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MissRachael

ST4 Clinical Scenario

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Hi everyone, 

 

I've got my ST4 general adult psychiatry interview on Tuesday. For those who have interviews in this round - do we think that station 3 (clinical scenario) is a CASC type situation where we have to assess an actor? Or is it a talking through what you would do with two interviewers.


Any thoughts ... 

 

Thanks and good luck to those who also have upcoming interviews,

 

Rachael

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In march 2012 and November 2012, ST4 interviews with clinical scenarios were discussion with two consultants with cross questions but for current interviews it seems that it will be like CASC!

Best of luck, please share your experience after your interview.

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I agree with psychdoc1, the scenario heading clearly mentions 'interaction with a patient or a relative' so it must be a CASC like scenario. However I would guess the standard expected would be higher.

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Hi everyone,

I've got my ST4 general adult psychiatry interview on Tuesday. For those who have interviews in this round - do we think that station 3 (clinical scenario) is a CASC type situation where we have to assess an actor? Or is it a talking through what you would do with two interviewers.

Any thoughts ...

Thanks and good luck to those who also have upcoming interviews,

Rachael

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How was the interview. I have mine in a few weeks. Was last station a CASC style?

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Hi everyone,

 

I was successful in my interview so just wanted to share about the clinical scenario as it was tough.

 

It's essentially a CASC-esque situation. For general adult this is speaking to a patient who has had a long history of self-harm and has been referred for assessment due to voicing suicidal ideation following a recent relationship break up. The task is to do a risk assessment and to come up with a joint management plan with the patient.

 

I'm not certain of what they were looking for in the interview, but I think it is about your general approach to managing someone who is angry, agitated, doesn't want to give information and wants to be admitted to hospital. Our patient was very reluctant to give any information, so I think it was less about obtaining a history (I couldn't get much of one at all) but more about empathising with her but being firm, and building up a rapport so that a management plan could be discussed jointly (it's this that takes the majority of the time).

 

In this case I think they want to see that you won't just admit everyone to hospital that demands it, and that you will be able to get her to at least think about alternatives such as intensive home treatment being a potentially better option that hospital. I asked her if I could obtain a collateral history from her family/previous CPN prior to making any decision together, and stressed that she needed to be part of taking some responsibility over her treatment, I also instilled hope by talking about longer term bio-psycho-social management options i.e. DBT, medication for comorbid conditions, support groups/CMHT input etc.

 

These are just some initial thoughts. It was tough because unlike CASC you left feeling that a proper history/risk assessment had not been done because she wouldn't engage, but of course that happens sometimes and are what collateral histories are there for. Just do what you would do in real life in that situation and don't rush to come to a decision within 15 minutes, it's more about the process than the outcome.

 

Sorry the answer is a bit muddled, hope it helps though, and good luck!!

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Hey Rachel

 

Thank you for your thoughtful comments of the interview.Could you feedback about the leadership skills/committment to speciality and the portfolio stations.

 

Were you asked about recent changes in mental health/Francis report etc

 

Your comments will be really appreciated

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Much appreciated, Thanks Rachael

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Thank you for taking the time to give feedback and well done on your success!!

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Hi  

 

Committment/leadership station is very much led by you. They will ask you to talk initially about what factors have led you to consider the specialty/how you have explored them. I talked about clinical, academic, management and personal factors. This covered a lot of leadership anyway so they just asked me to give a couple of examples and then asked how I would develop in higher training.

 

They don't really ask specific questions, but I'm guessing they would if you couldn't fill the time. So I would recommend really knowing what you are going to say and tailoring it to the person spec as much as possible i.e. team working, prioritisation, anayltical skills, communication etc. I don't think that they would ask specifically about the Francis Report. I didn't mention it but I did talk about clinical governance, the importance of it in general adult psychiatry and my experience so far of being involved in improving services.

 

Hope this helps,


Rachael

 

Hey Rachel

 

Thank you for your thoughtful comments of the interview.Could you feedback about the leadership skills/committment to speciality and the portfolio stations.

 

Were you asked about recent changes in mental health/Francis report etc

 

Your comments will be really appreciated

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Hi I have a ST4 forensic interview at the end of this month. Is anyone interested in practising

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Hi Rose i am interested but am doin OA

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hi rose...which deanery have you applied for?
Edited by Gurpal

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Hi

 

I recently had an interview featuring the same clinical scenario.

 

I too was unable to get much in the way of a history. The patient (actress) was deliberately trying to put me off my stride at every opportunity and at one point moved her chair so that her face was inches away from mine!

 

I siimply remained cool and calm and attempted to keep bringing her back to the topic. I also discussed alternatives to hospital admission and longer term therapies such as DBT etc. I remained non-committal regarding management saying that I'd like to abtain collateral information.

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