2019.2 KFP – public report

1 Musculoskeletal Disorders: Low-Back Pain

• Key Topics: Differential diagnosis, initial investigations, WorkCover certification.
• Candidate Performance: Candidates often failed to integrate the full medical history into their differential diagnosis, and many did not address the nuances of WorkCover claims effectively.
• Improvement Areas: Improvement is needed in utilizing comprehensive patient history to inform differential diagnosis and in understanding the legal and administrative aspects of occupational health claims.

2 Cardiovascular Health in Indigenous Populations

• Key Topics: Cardiovascular risk assessment, management planning.
• Candidate Performance: A common mistake was the repetition of information already provided in the patient’s history, along with suggestions for management plans that did not align with the specific details of the scenario.
• Improvement Areas: Candidates need to focus on creating management plans that are specifically tailored to the unique cardiovascular risk profiles of Indigenous populations, taking into account cultural and social determinants of health.

3 Obstetrics: Pregnancy Complications

• Key Topics: Management of acute dizziness and nausea in pregnancy, addressing domestic violence.
• Candidate Performance: Over-answering beyond what was requested and failing to adequately address the issue of domestic violence as it related to the patient’s care.
• Improvement Areas: Greater specificity in history taking and a more focused approach to identifying and managing the psychosocial aspects of patient care, especially in sensitive areas such as domestic violence.

4 Dermatology: Rash and Travel Vaccinations

• Key Topics: Diagnosis and management of a rash, advice on travel vaccinations.
• Candidate Performance: Candidates struggled with recommending appropriate travel vaccinations and often suggested vaccines that were either irrelevant or already part of routine immunizations.
• Improvement Areas: Improvement needed in recognizing the specific vaccine requirements based on travel destination and the patient’s immunization history, as well as in diagnosing and managing dermatological conditions effectively.

5 Pediatrics: Respiratory Distress and Vaccination Concerns

• Key Topics: Differential diagnosis for noisy breathing, urgent referral criteria, MMR vaccine hesitancy.
• Candidate Performance: Non-specific answers and a lack of focus on the mother’s specific concerns regarding the MMR vaccine.
• Improvement Areas: Emphasizing the importance of specific examination findings that indicate the need for urgent care and addressing vaccine hesitancy with accurate, evidence-based information.

6 Geriatrics and Chronic Disease Management: Blood Test Interpretation

• Key Topics: Interpretation of abnormal blood results, medication management.
• Candidate Performance: Inadequate consideration of the patient’s full medical context in explaining abnormal results and in proposing medication adjustments.
• Improvement Areas: Development of skills in integrating comprehensive patient information to inform clinical decision-making, particularly in the management of chronic diseases in older adults.

7 Urology and Infectious Diseases: Penile Rash and Hepatitis

• Key Topics: Diagnosis of penile rash, interpretation of hepatitis screen results, non-pharmacological management.
• Candidate Performance: Misidentification of lesions and incorrect interpretation of hepatitis screening results were common.
• Improvement Areas: Accurate diagnosis and understanding of sexually transmitted infections and their management, including interpretation of laboratory results.

8 Surgical Outcomes and Patient Complaints: Keloid Scarring

• Key Topics: Management of skin lesions, handling of patient complaints regarding keloid scarring post-excision.
• Candidate Performance: A focus on the keloid’s management rather than addressing the patient’s complaint about the informed consent process.
• Improvement Areas: Better communication about potential outcomes of procedures and effective handling of complaints to maintain patient trust and satisfaction.

9 Emergency Medicine: Severe Abdominal Pain

• Key Topics: Differential diagnoses, immediate management, and transfer protocols for severe abdominal pain.
• Candidate Performance: Lack of specificity in diagnosing and managing severe abdominal pain, leading to inadequate preparation for transfer to higher-level care.
• Improvement Areas: Clear identification of likely diagnoses based on clinical presentation and immediate management steps to stabilize the patient for transfer.

10 Endocrinology: Diabetes and Acute Illness

• Key Topics: Pharmacological management of a diabetic patient presenting with gastroenteritis, adjustment of diabetes management post-acute episode.
• Candidate Performance: Generalized approaches to gastroenteritis management without specific attention to the diabetic context of the patient.
• Improvement Areas: Tailored management of acute illnesses in patients with chronic conditions like diabetes, including specific adjustments to medication regimens based on clinical outcomes.

11 Psychiatry and Legal Medicine: Cognitive and Mood Changes

• Key Topics: Differential diagnoses for altered cognition and mood, considerations around power of attorney.
• Candidate Performance: Generic handling of legal aspects without directly addressing the patient’s specific situation and questions about power of attorney.
• Improvement Areas: Incorporation of a nuanced understanding of the legal and ethical considerations in medical practice, especially in the context of patient autonomy and decision-making capacity.

12 Respiratory Medicine: Spirometry and Chest X-ray Interpretation

• Key Topics: Differential diagnosis based on spirometry and chest X-ray findings.
• Candidate Performance: Common errors included misinterpretation of diagnostic tests and incorrect medication examples.
• Improvement Areas: Accurate interpretation of diagnostic tests and specific medication choices tailored to the patient’s condition.

13 Adolescent Medicine: Headaches and Psychosocial Issues

• Key Topics: Assessment of headaches in adolescents, exploration of psychosocial factors.
• Candidate Performance: Repetition of information from the stem and a lack of focus on psychosocial enquiry.
• Improvement Areas: Detailed psychosocial history taking and a structured approach to headache management, including appropriate dosing regimens.

14 Orthopedics: Shoulder Injury Management

• Key Topics: Diagnosis and management of shoulder injuries, patient information requests.
• Candidate Performance: Non-specific management plans and insufficient information provided to the patient’s queries.
• Improvement Areas: Developing tailored management plans and effectively communicating recovery expectations to patients.

15 Rural Medicine: Management of an Infected Animal Bite

• Key Topics: Examination findings for animal bites, management without hospital transfer.
• Candidate Performance: Overlooking key examination findings and the implications of delayed presentation.
• Improvement Areas: Recognition of complications associated with animal bites and addressing rural healthcare delivery challenges.

16 Reproductive Endocrinology: Primary Amenorrhea

• Key Topics: Differential diagnosis and management plan for primary amenorrhea.
• Candidate Performance: Failure to recognize the abnormality of the amenorrhea and providing conflicting information.
• Improvement Areas: Systematic approach to diagnosing and managing reproductive endocrinological disorders.

17 Obstetrics: Third-Trimester Bleeding

• Key Topics: Management of vaginal bleeding in late pregnancy, newborn care.
• Candidate Performance: Providing adult-focused responses for newborn issues.
• Improvement Areas: Tailored management of obstetric emergencies and neonatal care.

18 Oncology and Dermatology: Rapidly Developing Facial Lesion

• Key Topics: Diagnosis and management of facial lesions, patient communication about sequelae.
• Candidate Performance: General responses without addressing specific patient concerns.
• Improvement Areas: Specific diagnosis and management of skin lesions, effective communication of potential outcomes.

19 Otorhinolaryngology: Persistent Nasal Symptoms

• Key Topics: Management of chronic nasal discharge and blockage, antibiotic prescribing.
• Candidate Performance: Incorrect antibiotic dosing and not following contemporary guidelines.
• Improvement Areas: Adherence to guidelines for the management of nasal symptoms and accurate antibiotic prescribing.

20 Endocrinology in Pregnancy: Fatigue and Weight Gain

• Key Topics: Diagnosis and management of fatigue and weight gain in early pregnancy.
• Candidate Performance: Not considering the pregnancy context in management plans.
• Improvement Areas: Pregnancy-specific diagnosis and management, considering the unique physiological changes during pregnancy.

21 Psychiatry: Post-Hospitalization Symptoms

• Key Topics: Management of visual hallucinations and subsequent symptoms, medication side effects.
• Candidate Performance: Missing medication as a potential cause of symptoms.
• Improvement Areas: Recognition and management of psychiatric medication side effects, especially in complex cases.

22 Occupational Medicine: Commercial Driver’s License Medical

• Key Topics: Assessment for commercial driver’s license, handling patient’s employment concerns.
• Candidate Performance: Not addressing specific patient requests and misunderstanding documentation requirements.
• Improvement Areas: Understanding occupational health requirements and providing comprehensive patient support.

23 Hematology: Deterioration in Health with Hematological Signs

• Key Topics: Differential diagnoses for systemic symptoms, management of gout secondary to hematological conditions.
• Candidate Performance: Not recognizing signs of hematological malignancy and inappropriate gout management.
• Improvement Areas: Early recognition and management of hematological conditions and their complications.

24 Pain Management: Post-Surgery Pain and Opiate Reduction

• Key Topics: Management of post-operative pain, opiate prescription adjustment.
• Candidate Performance: Reiteration of existing medication plans and focusing on already decided opiate reduction.
• Improvement Areas: Comprehensive pain management strategies and appropriate medication adjustments post-surgery.

25 Cardiology: Management of Chest Pain in Ischemic Heart Disease

• Key Topics: Pharmacological management of chest pain, consideration of patient’s social issues.
• Candidate Performance: Overlooking social factors affecting patient care and nonspecific vaccine recommendations.
• Improvement Areas: Integrated care that encompasses both medical management and social support for patients with chronic conditions.

26 Immunology and Practice Management: Vaccine Cold Chain Breach

• Key Topics: Management of vaccination reactions, handling cold chain breaches.
• Candidate Performance: Lack of knowledge regarding actions following a cold chain breach.
• Improvement Areas: Understanding vaccine storage and handling protocols, emergency response plans for