OSCE No1 Question

general practice Aug 15, 2018

Okay, hi, it's Tom Rolley here for Graduate Medicine.

I've just completed my day and it was a pretty good day.

We had some interesting cases, but what I wanted to talk to you about is that some of you may be approaching the final hurdle in your path to fellowship, which of course, is the OSCE.

And if you're going to pass the AKT and pass the KFP, then you might think, "Hey, this OSCE thing, it should be pretty easy."

And you'd be right, because of course it is closest to how we actually work.

Yes, it's a little bit stylized, because it's eight minute cases, or it's the two long OSCE cases, which are 19 minutes.

But, you still need to know how to perform well, and also of course, it is quite a serious investment.

I think it's up around $4,000 plus mark at this point.

It's a long day as well, so you really want to have the capacity to step in confident, and actually know that yes, your money is well invested into getting this for RACGP and you've put the time in so you pass!


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Examination Performance

general practice Aug 05, 2018

Well, hello everyone.

I'll see if the signal works.

I just got home.

It's been a long day because I did a nursing home visit and also a visit to one of my patients who's had a crush fracture and is recovering in her home.

So it's like ten past six, it's date night and I'm going to take my wife out for dinner tonight .

If you're a GP and I'm going to strongly recommend you try out weekly date nights to preserve your relationship with your significant other, your wife or your husband or whoever that is in your life.

I'm finding it pretty helpful so that's the first tip for tonight.

What I wanted to cover is how exam performance can be impeded by poor preparation across clinical knowledge, critical skills and clinical reasoning.

So I was talking to a doctor yesterday and he said, "You know, Tom, I've know I've failed 2018.2."

I said, "Well, how can you know that?" And he said, "Well, the night before I hardly slept."

So I said, "Okay. What happened there?"

And as we dug a little...

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Success with the APHRA petition.

general practice Jul 30, 2018


Hi, its Tom Rolley for Graduate Medicine.


Just checking in with the good news.

I received an email this morning that the petition that I spoke about last week has been successful.

Now, for those who are unaware, this petition covered a rule whereby any complaints, whether founded or unfounded, would be registered on the a doctor's record.

So the petition target was 15,000.

I'm not sure exactly how they got.

Actually I do...

It's 16,640 signatories to it, and if you click the link it will say "Congratulations. Medical board reverses policy."

So this is clearly a win for common sense, and also respecting the work and the challenges we face as GPs. So, very excited.

If you did sign the petition, thank you.

It's an interesting experience of the world that we live in, that when we combine signatures or work together, we actually get results.

Alright, that's all I got for today.

Very happy that common sense has prevailed, and look forward to seeing you again...

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Different Experiences with two GP consults.

general practice Jul 30, 2018

So.. I had an interesting experience.

On Wednesday I was consulting.

The patient came in and said, "Gee, Tom. I think I've got Addison's."

Now if you're a GP or GP reg, you would realize that it's probably relatively unlikely.

So I go, "Great. I'm going to cut across to my key feature checklist," and I found no Addison's disease.

And I'm like, "Ahh, this is no good. What happened to my Addison's disease?"

So it's in production...

We haven't got it out yet.

But I then was stuck with the issue of going, "Okay, now I have to go to Murtagh's, I have to look up the web what's going on. Okay, that's right.

This is what Addison's about."

I got through it and I good reassure them  "I don't think you've got Addison's."

"But what was left for me, is the initial usefulness of the key feature checklist, if it had been there, was something that really powerful... I was like, "Damn, okay I've got to keep working on these things."

Now, today I had a different experience, which...

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My Health Records

general practice Jul 26, 2018


I thought I'd jump in on another topical discussion at the moment.

Thanks to everyone who supported the AHPRA petition!

Let's talk about My Health Record.

So that's been transferred from an opt-in system in Australia to an opt-out.

So, If you don't opt-out in the next 11 weeks then you will automatically get a My Health Record created for you.

Now the word on the street is, I don't have direct evidence of this, but many GPs are not opting in for this.

They are opting out.

And yes, indeed, I am opting out too.

I don't see a lot of upside benefit for myself.

I don't have any chronic diseases, and yet the downside risks include identity theft, and I'd already opted out by the time that the Singapore data theft had occurred.

If you're not aware of this, 1.5 million records were taken.

Now apparently, there's no health records stolen, but just people's date of birth and all of their identifying information.

Now, if that's not a risk for identity theft, then I'm not...

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Sign the petition

general practice Jul 24, 2018

It's Tom Rolley here for GraduateMedicine.com.

I wanted to jump in around a petition that you hopefully know about.

If you don't, then this is to bring your awareness to this petition.

Now, this petition is about AHPRA going ahead with an idea that they will basically publish all complaints against doctors, even if those complaints are investigated and are found to be false and ridiculous or whatever's going on, that they're not actually saying anything wrong was done by that doctor.

They're still going to go ahead and make that complaint against that doctor's name on the register on the AHPRA website.

So this petition's saying, "Hey, this is ridiculous. How can you publish this stuff against a doctor when there is not even anything that they did wrong?"

Now, and you might think, "Oh, well, most complaints are actually legit, they are all going to be upheld."


According to doctorportal, where I was sent this link from, they say at least 70-plus percent of these are dismissed,...

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The Problem of General Practice Today

general practice Jul 16, 2018

Hello and welcome to this Facebook Live. My name is Dr. Tom Rolley for GraduateMedicine.com.

I wanted to drop in to what I see as the essential problem of being a GP, at least in Australia in the 21st Century.

And while there's a lot of distractions around about are we getting paid enough, how do we do this, how do we do that, what's the training doing?

But to me what we are actually facing is a problem of too much information.

Too much information that essentially, as general practitioners, having to go across all of the different subspecialties and then have a patient walk in with an undifferentiated problem and be able to work out what's going on. But once we get into what's going on, each of those problems has actually got vast amounts of information.

And to me it's just not possible anymore to be an authority on all of the potential topics that we have to be across as good GPs.

So the outcome of this problem is often ... well let's take it to the exams. We train on getting...

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Pallative Care in GP and the Fear of Dying

general practice Jul 05, 2018

Hello, my name is Tom Rolley.

I  wanted to discuss palliative care and had a patient come in this morning and he was disappointed in that how care that her, one of her parents received.

And for me it's an interesting one cos it can bring up a lot of my own fears, in dealing with palliative care and if I'm not aware of that stuff, then I can end up not providing good management in pal care. So what I think about palliative care?

As a doctor, it forces me to confront my own fear of death.

That's what I see when I hear about palliative care not being done well, I'm like okay, I just wonder whether that doctor's not okay with the fact that they're going to die.

And therefore when they're treating the patient in palliative care, therefore it is hard to actually be okay with making decisions.

So some of the things that come up are, "Should we transfer this patient to a different hospital to get this thing looked at?"

No. They're dying, they are dying.

They're close to death.


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What topics to study for the FRACGP Exams?

Congratulations to all GP registrars who sat the 2017.1 FRACGP exams last Saturday, 4 February 2017.

Well done on all your hard work and study over the past six to 12 months!

As we pass another round of AKT / KFP exams, we can now look forward to preparation for the next round of FRACGP exams in 2017.2, which is just over five months away on 15 July 2017.

So, what are the key topics to prepare for the FRACGP Exams?

It's like the million-dollar question ... give me the answers to pass the exams?! If only there was a straight answer and that simple...

And that is much like being a General Practitioner in an everyday practice. The challenges, problems and key features that patients bring to us are varied from simple to challenging, from paediatrics to geriatrics. It is what makes GP such a great job (in my opinion!)

There are however, a few very valuable resources provided by the RACGP to help you get started in preparing for the FRACGP exams...one being a very useful article that...

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