mrcgp international prof. dr nagwa eid sobhy
DESCRIPTION
TRANSCRIPT
The Trainers Workshop
MRCGP INTERNATIONALDr Nagwa Eid Sobhy
Chair of Examination Committee
Principles of MRCGP[INT]Endorsing those Examination Bodies who consider the:
• Purpose – in the broader context of Family Medicine
• Content – the curriculum development describing those competencies required for the Family Doctor
• Assessment package planning and ‘blueprinting’ of curriculum
• Standards – how these are set and are calibrated to the MRCGP
• Procedures – quality assurance including examiner training and statistical analysis
Background to the MRCGP[INT]• Support the development of General Practice / Family
Medicine worldwide
• Assist in raising the standards of the discipline
• Explore the different competencies required by Family Doctors in varying cultures, health systems and epidemiology
• Accredit locally developed assessments
• Award in addition to the local qualification
• Award equivalent to Hospital Based Specialities
BackgroundSince the first accredited MRCGP[INT] site in 2001,
examination diets have been run inThe Middle East:• Oman - 7 diets since 2001• Kuwait - 6 diets since 2005• Dubai - 3 diets since 2006South East Asia Pacific:• Brunei - 5 diets since 2002South Asia: Bangladesh, India, Nepal, Pakistan and Sri
Lanka - 2 diets since 2007
BackgroundEurope: The MRCGP examination in UK is the quality assurance
standard for accreditation Kosovo, Malta, Greece are currently working towards
accreditationMiddle East Egypt, Qatar are currently working towards
accreditationElsewhere: Uganda and Nigeria are currently exploring this
accreditation
Assessment Package
• Progression exam• Workplace based assessment• Applied knowledge test• OSCE
Workplace based assessment
• Portfolio • Trainers’ Appraisal Report TAR• Direct Observation of Procedures DOPS
PortfolioSuggested Contents of the portfolio: -
• Research project (thesis)• Logbook• Audit of medical records• Critical appraisal• Continuous Professional Development• Foundation courses• Advanced Life Support • IMCI• Reflective Diary
PortfolioResearch project (thesis): • It will be presented by the end of training as a
prerequisite for the final exam. • Special emphasis on some subjects that might
affect outcomes of health-care: patient safety patient satisfaction Audits referral
Portfolio
Logbook:
• It contains: common casescommon procedures critical incidents.
Portfolio
Audit of medical records:
• each trainee will provide an audit of around ten medical records of patients he served
• this audit will be conducted every FHC rotation
PortfolioDocuments of Continuous Professional
Development:
• journal clubs• Critical appraisal of two related articles per
rotation in FHC.• attended workshops• training courses• conferences
Portfolio• Foundation courses: Communication skills Basics of research Ethics Medecolegal aspects Health care system
• Advanced Life Support • IMCI
Portfolio
Reflective Diary: • action plan recorded every rotation in FHC
according to the feedback from scientific supervisors
Portfolio
Reflective Diary: • action plan recorded every rotation in FHC
according to the feedback from scientific supervisors
Training Appraisal Report; TAR
Frequency of assessment:
• Annual formative report from the trainer and the academic supervisor to evaluate the trainee's achievements and progress
Direct Observation of ProceduresDOPs
Frequency of assessment: • by the end of each rotation the trainee is
expected to provide evidence of competency in performing all listed procedures in this rotation
WBA – the nMRCGP tools
• CBD (case based discussion) • COT (consultation observation tool)• PSQ (patient satisfaction questionnaire)• MSF (multi-source feedback)• mini-CEX (clinical evaluation exercise)• DOPS (direct observation of procedural skills)
Assessment Package
• Progression exam• Workplace based assessment• Applied knowledge test• OSCE
Progression exam• Timing: after the end of the training of the first year
• One paper: MCQs one best single answer • Aim of this exam: early detection of student difficulties
Progression exam
• Introduction to Family medicine and Community Medicine 25• Internal Medicine/ Geriatric 35• Pediatrics/Child Health 25• Psychiatry 15
Assessment Package
• Progression exam• Workplace based assessment• Applied knowledge test• OSCE
Applied knowledge test
Applied knowledge test: 200 MCQs• Paper I: 3 hours 180 MCQs mostly with clinical scenario in• Paper II: 03 minutes 20 MCQs on ECG, X-ray, Lab report, skin rash,
photo of physical sign, growth curve,…..
Blueprint of Applied knowledge test paper: I• Internal medicine & geriatric 30%• Obstetric & Gynecology 15%• Pediatric 14%• Emergency & orthopedics 10%• Community medicine 8%• Psychiatry 7%• Surgery 5%• ENT 4%• Ophthalmology 3%• Dermatology 2%• Male reproductive health 1%• Family life cycle 1%
Common Reference Materials:
• National Guidelines• Oxford Textbook of Primary Medical Care• Rakel Textbook of Family Medicine• Rakel Essentials of Family Medicine• Current Textbook of Family Medicine
Other Reference Materials :
• Taylor Textbook of Family Medicine• NICE Guidelines• SIGN • BNF
Blueprint of Applied knowledge testpaper II
• Photo of physical signs 40%• Lab report 24%• X-ray 16%• ECG 12%• Growth curve & others 8%
Photo of physical signs; 40%
• Skin• Eye• Endocrine• Musceloskeletal• Facial appearance,……
Lab report; 24%
• CBC• Urine / stool• Chemistry• Viral
markers• Immunology• Others
Fasting 110-1262hr <140
Fasting <1262hr 140- <200
Fasting >1262hr >200
ImpairedFasting
Glycemia
ImpairedGlucose
Tolerance
Diabetes Confirmed
X-ray; 16%
• Chest• Heart• Abdomen• bone
ECG; 12%
• Arrhythmia
• Chamber enlargement
• Ischemia & infarction
Others; 8%
• Growth curve,……
Assessment Package
• Progression exam• Workplace based assessment• Applied knowledge test• OSCE
OSCE
Fourteen stations• Twelve stations: CSA: clinical skill assessment. at least 4 cases with physical signs• Two stations: Procedure and/or focused clinical exam
First Mock Exam
• Mock AKT exam (23/3/2009)• Mock CSA exam (15/4/2009)