System of Medical Examination.

BY

Dr. Mohammad Aslam Baloch

F.R.C.S
Prof. of Surgery B.M.C
 Introduction
Motive of passing examination is to achieve
the result of your struggle, It is the nature

• It is the nature for every struggle people

expect some fruit

• So you study full time naturally expecting

success and the success depends on
working in a set framework.
 Components of Clinical Exam are
(A)
1. M.C.Q
2. Theory
» Long essay 60%
» Short essay.
(B) Clinical
» Short Cases
» Long cases 60%
» Table Viva
 M.C.Q
• Negative Marking
• No Negative Marking

Different Responses

1. True or False
2. Tick Correct one
3. Yes or No
Normally in countries where the Medical
Education Departments are advanced in
Medical colleges, there is negative marking.
e.g.
• Correct response--------------80
• Incorrect response------------10
• Not Attempted------------------10
Total Marks would be--------70
 Theory
In most of postgraduate centers +
Advanced countries it is short essay
questions, long essays are absolute.

Suppose: there are different words we

Stress.
1. Define
2. Discuss
3. Describe
4. Enumerate
5. Give detail account & so on
You start your answers with
- Heading &
- Sub Headings
start with most common problems/
symptoms/conditions & with highest to lowest
frequency of occurrence.
- Minor or Foot notes or rare are not needed & do
not carry any markings in fact.
 In our college it is the long question we rely
upon.
 Benefits are
1. You cover most of topics
2. there is better assessment of candidates
 Long Essay

• We expect that candidate may be able to

follow what the examiner wants.
• He/ She knows the basic principles.
• Understands the Basic principles and
stresses on safety.
• Proves He/She is safe for him/herself as
well as for the patients.
Always at the end define in the form of
conclusion/ Result what was your
question about & what do you think
of that in the end ( any improvements,
changes, future trained at the back of
your mind.)
 Clinical

Three parts,
1. Short cases
2. Long cases
3. Table Viva
 Short cases
You are shown
2---5 cases.

Basic Idea is to test your clinical skills.

e.g.
you may be asked to exam Groin, Neck,
abdomen etc.
Please make sure you are following
fundamental clinical principles
1. Not to ask any questions
2. Examiner is asking Examine
3. Make sure you are asking permission from
patient to examine after your introduction to
patient.
4. Proper exposure of the part
5. Systemic examination following the Routine
6. At the end of the examination give your
diagnosis.
7. Arguments in favour of Diagnosis
You may be asked about the investigations
& treatment of that patient in brief.

• The different approaches/ options in

management.

• The differential diagnosis.

 Long cases

• Ample time
• Only one case
• It makes up
- Clerking of patients
- Examination
- Sensible investigations
- Differential diagnosis
- Final probable diagnosis
- Options for management
 Continued

Here examiners is testing your all

capabilities as well as your confidence,
decision making.

He is also looking at your approach for

management and safety of patient and whether
you are safe or not
 Continued

He is always keen to look whether you are

well organized & you have a systemic
approach or you are just guessing & have
got some hints/feedback from the house
officer who is working in the ward
 Do not forget

That your examiner is observing your

dressing, apron, the stethoscope & the
Other necessary tools you are carrying.
 Table Viva
• In Table Viva you may be shown different
X-rays, U/sounds, M.R.I/ C.T Scan/
Instruments.
• The idea is to have a starting point these
we call appetizers.)
• Then you go on to different topics for
discussion.
 Continued
All examiners who understand their subject &
have been examiners.
Agreement is

• The student has to pass all the components or at

least two components of clinical examination.

• They have to pass written as well as clinical part.

• Failures in clinical/written examination is fail.

 Can the examiners be fair?

Most of examiners are fair & follow the

following criteria of examination.
1. It is aggregation of all components of
examination.
2. There is not a single examiner involved
but 3—4 examiners.
3. There are observers who give examiner
some feedback.
 Biast Examiner

1. If the asking question in language which

is not acceptable (Harsh, agree looking &
Tenting etc.)
2. Has a bad repute being partial or Harsh.
3. Has been threating the students before
examination or giving them an
impression that they have to face them
on other side of table with bad
consciquences!!
 I Have failed though I have
been a good student?

Categories of Questions
1. Basic Questions
– This is regarging basic Basic Principles,
Decision Making, approach of students &
regarging safety.
– you have to have these questions
answered with confidence.
– These questions decide whether you pass
or Fail?
2. Marks obtaining questions
These are slightly Advanced questions
examiner has made a decision that you
have passed & wants to give you more
marks.
If you reply them you get more marks if not
you will not fail.
3. Position obtaining questions

If you have been good & have confidently

& nicely attempted your first two
components you are a different category
of student & you qualify for some position.
If they would be Advanced questions &
may have controversies which you have to
give your opinion & discuss them.
 In Conclusion

• I believe if you are a regular student.

• You understand your responsibilities
imparted by your family.
• You are doing justice to the job give
( off course only study ) according to your
conscious.
• You study 3—4 Hours daily.
There is no way you may be unsuccessful.