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Dr Scaife's article reminded me of my own experiences in the MRCP
final examination back in the early 1980s.
My "long case" was a law student who looked as fit
as a fiddle. The history was that she had somehow contracted pulmonary
tuberculosis - it was never discovered how - and was now almost at the end
of her 6 months of antituberculous therapy. She gave me all of the
relevant facts and figure related to her management, and clearly had been
an examination patient on several occasions.
I proceeded to do my physical examination, which was completely normal
for a healthy young woman. When I had finished, I told her that, and asked
her if there was anything else I should know. She said "Yes, the Professor
examined me this morning and said my exam was normal except for a little
patch of "whispering something-or-other" just below my left shoulder
blade." I istened again, and sure enough, there was a little area not much
bigger than my stethoscope bell in which classical whispering pectoriloquy
was evident.
The grand examiners then came in and I gave my account of the patient's
history. "And what physical signs did you find, doctor?" At which I stated
that the examination was entirely normal apart from a very small area of
whispering pectoriloquy just inferior to the left scapula. The Professor's
eyebrows rose just a little, and he asked me to demonstrate the sign,
after which, in best MRCP tradition, the only acknowledgement was a little
nod from the Professor, and a little smile from the patient...
All Examinations are a game of cards. You can't control the hand you are
dealt, but you can control how you play the hand!
Competing interests:
None declared
Competing interests:
No competing interests
09 October 2004
Stephan Larsson
Radiation Oncologist
Vancouver Island Cancer Centre, Victoria, BC, V8R 6V5
"Real" patients are often helpful....
Dr Scaife's article reminded me of my own experiences in the MRCP
final examination back in the early 1980s.
My "long case" was a law student who looked as fit
as a fiddle. The history was that she had somehow contracted pulmonary
tuberculosis - it was never discovered how - and was now almost at the end
of her 6 months of antituberculous therapy. She gave me all of the
relevant facts and figure related to her management, and clearly had been
an examination patient on several occasions.
I proceeded to do my physical examination, which was completely normal
for a healthy young woman. When I had finished, I told her that, and asked
her if there was anything else I should know. She said "Yes, the Professor
examined me this morning and said my exam was normal except for a little
patch of "whispering something-or-other" just below my left shoulder
blade." I istened again, and sure enough, there was a little area not much
bigger than my stethoscope bell in which classical whispering pectoriloquy
was evident.
The grand examiners then came in and I gave my account of the patient's
history. "And what physical signs did you find, doctor?" At which I stated
that the examination was entirely normal apart from a very small area of
whispering pectoriloquy just inferior to the left scapula. The Professor's
eyebrows rose just a little, and he asked me to demonstrate the sign,
after which, in best MRCP tradition, the only acknowledgement was a little
nod from the Professor, and a little smile from the patient...
All Examinations are a game of cards. You can't control the hand you are
dealt, but you can control how you play the hand!
Competing interests:
None declared
Competing interests: No competing interests