2021.1 KFP – public report

Case 1: Pediatrics/Respiratory Medicine

• Subject Area: Management of acute respiratory distress in an infant.
• Key Topics Discussed: Identification of physical examination features warranting hospital admission, post-discharge management, and handling unexplained bruising.
• Candidate Performance: Lack of specificity in physical examination details.
• Improvement Areas: Focus on specific, relevant physical examination findings indicative of respiratory distress and appropriate management of potential child abuse signs.

Case 2: Orthopedics/Sports Medicine

• Subject Area: Acute shoulder injury management and complaint handling.
• Key Topics Discussed: Physical examination signs for shoulder injuries, risks associated with subacromial injections, and addressing patient complaints.
• Candidate Performance: Inadequate management of patient complaints and misunderstanding of clinical context.
• Improvement Areas: Specific identification of shoulder injury signs, clear communication of procedure risks, and effective complaint resolution strategies.

Case 3: Pediatrics/Infectious Diseases

• Subject Area: Management of fever and rash in an infant with recent overseas travel.
• Key Topics Discussed: Differential diagnoses for fever and rash, specific examination features, and immediate management actions.
• Candidate Performance: Lack of knowledge on managing infectious illnesses in returning travelers.
• Improvement Areas: Enhance knowledge on common travel-related infections and focus on specific, relevant examination findings and management strategies.

Case 4: Pharmacology/Cardiology

• Subject Area: Management of high-risk medication prescriptions and ECG interpretation.
• Key Topics Discussed: Safe prescription practices for clonidine and oxycodone, ECG interpretation, and immediate management actions.
• Candidate Performance: Gaps in ECG interpretation and safe medication management.
• Improvement Areas: Develop a thorough understanding of ECG findings and implement safe prescribing practices for high-risk medications.

Case 5: Pediatrics/Urology

• Subject Area: Pediatric immunization and genital abnormalities.
• Key Topics Discussed: Addressing parental concerns about immunization, management of abnormal scrotal findings.
• Candidate Performance: Failure to address specific immunization concerns and manage genital abnormalities.
• Improvement Areas: Provide clear, evidence-based information on immunization and knowledge on managing scrotal abnormalities.

Case 6: Obstetrics/Gynecology

• Subject Area: Management of early pregnancy and complications.
• Key Topics Discussed: Initial investigations for pregnancy, management of vaginal bleeding, and differential diagnoses.
• Candidate Performance: Inappropriate consideration of gestational stage in management.
• Improvement Areas: Tailor management strategies to the stage of gestation and specific clinical presentation.

Case 7: Gynecology

• Subject Area: Acute abdominal and pelvic pain management.
• Key Topics Discussed: Differential diagnoses, initial investigations, and non-pharmacological management of dyspareunia.
• Candidate Performance: Differential diagnoses not aligned with clinical features.
• Improvement Areas: Provide specific, relevant differential diagnoses and initial investigations, and understand non-pharmacological management options for dyspareunia.

Case 8: Geriatrics/Orthopedics

• Subject Area: Management of wrist injury and prevention of future fractures in an elderly woman.
• Key Topics Discussed: Initial management of wrist injury, managing unresolved clinical features, and fracture risk reduction.
• Candidate Performance: Non-evidence-based management strategies.
• Improvement Areas: Adhere to evidence-based guidelines for injury management and fracture prevention strategies.

Case 9: General Medicine

• Subject Area: Interpretation of blood investigation results and physical examination for differential diagnosis.
• Key Topics Discussed: Differential diagnoses based on blood results and specific examination findings.
• Candidate Performance: Lack of specificity in differential diagnoses and examination findings.
• Improvement Areas: Focus on relevant, specific differential diagnoses and examination findings that confirm the most likely diagnosis.

Case 10: Obesity Management

• Subject Area: Weight loss assistance and management post-gastric bypass.
• Key Topics Discussed: Weight loss management options, initial investigations post-gastric bypass.
• Candidate Performance: Limited knowledge of current guidelines and failure to address key features of the patient’s history.
• Improvement Areas: Broaden knowledge on weight management strategies and tailor management to the patient’s specific clinical context.

Case 11: Psychiatry

• Subject Area: Management of complex medical history and auditory hallucinations.
• Key Topics Discussed: Interpretation of blood results, non-pharmacological management strategies, and handling of hallucinations.
• Candidate Performance: Inappropriate focus on pharmacological interventions for a non-pharmacological management scenario.
• Improvement Areas: Emphasize non-pharmacological management approaches and specific strategies for managing psychiatric symptoms.

Case 12: Dermatology

• Subject Area: Management of a new skin lesion in an older adult.
• Key Topics Discussed: Expected dermatoscopy findings, management options, and skin cancer risk reduction.
• Candidate Performance: Generalized examination findings and management options.
• Improvement Areas: Provide specific dermatoscopic clues, evidence-based management options, and targeted skin cancer prevention advice.

Case 13: Rheumatology

• Subject Area: Acute foot swelling in a Torres Strait Islander man.
• Key Topics Discussed: Likely diagnosis, initial management, and non-pharmacological management for foot swelling.
• Candidate Performance: Generalized responses lacking specificity.
• Improvement Areas: Focus on culturally sensitive, specific diagnostic and management strategies for acute foot swelling.

Case 14: Pulmonology/Geriatrics

• Subject Area: Chronic cough management and acute visual deterioration in an elderly woman.
• Key Topics Discussed: Management based on spirometry findings, hospital admission criteria, and management of acute visual loss.
• Candidate Performance: Poor interpretation of spirometry results and inadequate management plans.
• Improvement Areas: Enhance understanding of spirometry interpretation, recognize indications for hospital admission, and manage acute visual changes effectively.

Case 15: Postpartum Care

• Subject Area: Management of postpartum fatigue and breastfeeding advice.
• Key Topics Discussed: Diagnosis of postpartum fatigue, initial investigations, and breastfeeding advice for working mothers.
• Candidate Performance: Overemphasis on pharmacological management for non-pharmacological scenarios.
• Improvement Areas: Focus on non-pharmacological support for postpartum fatigue and practical breastfeeding advice for working mothers.

Case 16: Dermatology

• Subject Area: Management of acute painful rash in a patient with intellectual impairment.
• Key Topics Discussed: Diagnosis and management of skin condition, obtaining informed consent for new skin lesions.
• Candidate Performance: Inadequate consideration of patient’s holistic needs and medical history in consent process.
• Improvement Areas: Tailor management to the patient’s cognitive ability and ensure informed consent processes are adapted appropriately.

Case 17: Pediatrics/Otorhinolaryngology

• Subject Area: Acute otitis media management and follow-up for persistent symptoms.
• Key Topics Discussed: Pharmacological management of acute ear pain and fever, and handling persistent purulent ear discharge.
• Candidate Performance: Incorrect dosing in pharmacological management.
• Improvement Areas: Ensure accurate dosing in pharmacological management and follow evidence-based guidelines for persistent otitis media.

Case 18: Urology/Geriatrics

• Subject Area: Chronic urinary frequency in an elderly woman.
• Key Topics Discussed: Differential diagnoses, pharmacological management, and lifestyle modifications.
• Candidate Performance: Responses lacked specificity and relevance to elderly care.
• Improvement Areas: Provide age-appropriate differential diagnoses, evidence-based pharmacological management, and practical lifestyle advice.

Case 19: Pulmonology/Infectious Diseases

• Subject Area: Management of cough with purulent discharge and hemoptysis.
• Key Topics Discussed: Differential diagnoses based on chest X-ray findings and initial investigations for suspected serious condition.
• Candidate Performance: Failure to address serious underlying conditions.
• Improvement Areas: Recognize and manage potential serious conditions based on clinical and radiographic findings.

Case 20: Neurology

• Subject Area: Dizziness, nausea, and vomiting with a focus on central causes.
• Key Topics Discussed: Differential diagnosis for dizziness and specific examination findings for central causes, management of skin lesion.
• Candidate Performance: Repetitive and nonspecific examination findings.
• Improvement Areas: Identify and articulate specific findings indicative of central neurological causes and manage skin lesions with precision.

Case 21: Geriatrics/Palliative Care

• Subject Area: Advanced care planning and management of end-of-life symptoms.
• Key Topics Discussed: Elements of advanced care planning, handling requests for hastening death, and symptom management in dementia.
• Candidate Performance: Gaps in advanced care planning knowledge and handling of sensitive end-of-life requests.
• Improvement Areas: Comprehensive understanding of advanced care planning, ethical handling of requests for hastening death, and symptom management in terminal conditions.

Case 22: Cardiology/Aboriginal Health

• Subject Area: Management of heart failure in an Aboriginal man.
• Key Topics Discussed: Pharmacological management of heart failure, cultural safety in healthcare, and chronic disease management in Aboriginal communities.
• Candidate Performance: Insufficient knowledge on culturally safe healthcare practices.
• Improvement Areas: Implement culturally safe healthcare practices, tailor chronic disease management to patient’s cultural background, and engage in effective chronic disease recall systems.

Case 23: Emergency Medicine/Surgery

• Subject Area: Acute abdominal pain management in a rural setting.
• Key Topics Discussed: Initial investigations, immediate management actions for acute abdomen, and post-surgical care.
• Candidate Performance: Lack of specificity in management and consideration of rural healthcare challenges.
• Improvement Areas: Prioritize immediate and specific investigation and management strategies suitable for rural healthcare settings.

Case 24: Ophthalmology

• Subject Area: Acute eye redness and pain management.
• Key Topics Discussed: Examination for ocular conditions, investigation for underlying causes, and immediate management.
• Candidate Performance: Incorrect differential diagnoses and investigation choices.
• Improvement Areas: Accurate assessment of ocular conditions, appropriate selection of investigations, and timely management actions.

Case 25: Dermatology

• Subject Area: Management of malodorous feet.
• Key Topics Discussed: Diagnosis of foot conditions, pharmacological and lifestyle management.
• Candidate Performance: Overcoding and providing excessive, irrelevant answers.
• Improvement Areas: Provide concise, relevant pharmacological treatments and practical lifestyle modifications.

Case 26: ENT/Psychiatry

• Subject Area: Chronic tinnitus management.
• Key Topics Discussed: Examination indicative of serious underlying causes, initial investigations, and non-pharmacological management.
• Candidate Performance: Management actions not tailored to clinical presentation.
• Improvement Areas: Focus on specific, relevant examination findings, appropriate investigations, and effective non-pharmacological management strategies.