I’m glad you’re reading this post. It may make the difference between passing and not passing your exam. The following blood-curdling scenario and it’s solution may occur either at the Adult Psychiatry Part 2 exam or the Child & Adolescent Psychiatry Part 2 exam. And this frightening scenario is ….
Your Board Patient Tells You She Has a Medical Disease You Never Heard Of
Here is a real-life example sent in to me from the recent Psychiatry Oral Boards.
“My patient had Ehler Danlos Syndrome and they asked me about it- I said that I know it is a connective tissue disorder but have to read on that. Then they asked me about the Treatment impact of Ehler Danlos on the patient’s psychiatric condition which I said will coordinate with her medical doctor. Then they asked me how do we treat autoimmune disorders and I explained the meds and psychiatric impact.”
Ehlers-Danlos Syndrome is quite rare – you very well may not know single thing about it. (And yes, it is a connective tissue disorder.) So how can you answer any questions about it? Clearly, you can’t pull out your favorite medical manual or software program at the exam. So that means you can only rely on yourself, right?
Wrong!
It seems to make sense that you are limited to your own knowledge when at the exam. But you are not. You have the patient’s knowledge base available to you! How can this be? Here’s how.
When you have a patient with a medical or neurological condition you’re unfamiliar with, the first step is to become aware of this state of affairs during the interview itself, while the patient is still with you. Then you can ask the patient a series of questions THAT PRESUME NO KNOWLEDGE ABOUT THE CONDITION and yet sound quite intelligent. People with serious medical conditions often know a huge amount about the disorder. And even when they don’t, they can still share their experience of having the disorder with you.
To make my point sharper, I will make up a disease name and use it in the sample questions I’m about to give you. I will call my completely-unknown-to-me medical condition, Rumpelstilskin Disease. I know, I’m a true comedian. We pick up the interview right after the patient tells me he has Rumpelstilskin Disease.
- “When were you diagnosed with Rumpelstilskin Disease?”
- “What clinical symptoms do you have from it?”
- “Does Rumpelstilskin Disease limit your day-to-day abilities?
- “Is pain or discomfort a part of having it for you?
- “What is the nature of your treatment for Rumpelstilskin Disease?”
- “How well is it working for you?”
- “Have you and your doctor talked about other treatments that might help additionally?”
- “Have you and your doctor talked about your prognosis and what having Rumpelstilskin Disease may mean for you as you get older?”
- “Does anyone else in the family have Rumpelstilskin Disease?”
- “How are they doing?”
- “And how about you? How well are you coping with having this disease?”
- “Do you think any of your emotional issues are related to having Rumpelstilskin Disease?”
OK. There you have it – a whole series of sensitive, pertinent questions about something I’m clueless about.
And one more thing. The examiners very well may not care how much you know about especially uncommon medical conditions. Telling them you would look up the information in this case, as our candidate did, is acceptable.
But what the examiners will expect from you is that you do evaluate the impact of a serious medical condition during the interview and incorporate the problems that arise due to it a part of your treatment plan. If you know me, you know I’m always pointing out that you need to address all the problems on Axes I through IV in your treatment plan. This means taking medical problems and psychosocial life problems into account. Right? Right! Great.
Now on to an announcement.
Beat The Boards! Part 2 Course Bonus Available
I am in the process of upgrading our Beat The Boards! Psychiatry Part 2 Course Home Study Materials. If you are already signed up for an upcoming course, as many readers already are, don’t worry. We will mail you the new bonus DVDs I’m working on this month and in early August.
The Bonus is this. If you register for any of the upcoming Beat The Boards! Psychiatry Part 2 Courses in JULY, you will receive 2 additional DVDs for no additional charge. They will be priced at $97 each after that. One DVD will include one mock exam with a candidate interviewing a very difficult patient and the other DVD will include a Model Oral Board Interview with a complex patient.
If you are interested in registering, I’d encourage you to do so this month so you get the additional DVDs for free. You can call Ramona at 877-225-8384.
Today’s Quote
“Change is the law of life. And those who look only to the past or present are certain to miss the future.” – John F. Kennedy