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Modified Essay Question
Prof.Yousef Abdullah Al Turki
MBBS,DPHC,ABFM
Professor and Consultant Family Medicine
College of Medicine, King Saud University
Aims and Objective( General)
• To assess the candidate’s ability to
conduct a good consultation and problem
solving skills.
• To assess the candidate ability to identify
the nature of a prevented problem and to
propose a range of solutions
• To identify and evaluate the candidate
attitude to the situation described.
Aims and Objective (Specific)
• The Assessment of adequate consultation
skills.
• The comprehensive of history-taking.
• Explaining to the patient the nature of his
problem's).
• Selection of relevant health promotion and
prevention.
continue
• Relevant clinical examination.
• Relevant laboratory investigation.
• Appropriate management strategy.
• Rational prescribing.
• Effective referral if needed.
• Evidence of being a competent and safe
doctor.
Common theme in M.E.Q
• All aspect of clinical and preventive family
medicine.
• Problem and difficult patients.
• Psychological problems in individuals and
families.
• Consultation process.
• Practice organization.
continue
• Relationships with colleagues and others.
• Controversial and new topics.
• The doctor’s own feeling.
• Ethics and attitudes.
CASE SCENARIO
• IBRAHIM 53 YEARS OLD COME TO PCC AT KKUH C/O
BAD WOUND IN HIS RT FOOT. HE IS KNOWN DM AND
HYPERTENSIVE PATIENT FOR THE LAST 15 YEARS.
WHEN YOU REVIEW HIS FILE YOU NOTICE MOST OF
PCC VISITS WERE FOR REFILL. HE IS SMOKER FORTHE
LAST 30 YEARS. HE LOOK OBESE. BMI IS 37. HIS LAST
HBA1C WAS 11.5
HOW YOU WILL PROCEED DURING THIS
CONSULTATION?
CASE SCENARIO
• AHMED 20 YEARS OLD COME TO PCC AT KKUH
TO DO MRI FOR HIS RT KNEE. PATIENT WAS
SEEN IN PRIVATE CLINIC AND TOLD TO DO
MRI TO DIAGNOSE HIS KNEE PROBLEM. HE
CANNOT DO IT IN PRIVATE HOSPITAL BECAUSE
IT IS EXPENSIVE.
HOW YOU WILL PROCEED DURINGTHIS
CONSULTATION?
How should you set about
answering M.E.Q ?
• Read the scenario carefully.
• Every word has some significance.
• Think in broad terms about the whole of
the case, not just about the superficial
symptoms or diagnosis described.
• Think of the context in which the situation
arises, and the resources you can
command to deal with it.
continue
• Think of what you need to do to convey
your ideas and implement them.
• Keep it brief - notes or statement.
• Time – divide equally
• Practice family medicine – justify your
action and how? Who will help you and
how?
• Structure your answer to cover all aspects.
Marking schedule
• What are the contents of marking
schedule of Modified Essay Question?
Clinical competence
• Assess of physical state, relevant clinical
examination, appropriate investigation,
and evaluation of therapy.
• Psychological, social, and environmental
factors.
• Family situation and support.
• Compliance.
Practice management and
organization
• Communication, team work.
• Follow up.
• Value of regular visits.
• Shared care.
Patient autonomy and expectations
• What does the patient want or expect?
• What does the doctor think is possible?
• What is realistic in the circumstances?
Attitudinal factors
• How does the candidate consider
resources outside the practice?
• Implication of social class and doctorpatient relationship.
R.A.P.R.I.O.P
• R- reassurance
• A- Advice
• P- prescribe
• R- referral
• I- investigation
• O- observe
• P- plan
Sttot and Davis
• Management of presenting problems.
• Management of continuing problems.
• Modification of help-seeking behaviors.
• Opportunistic health promotion.
Thanks with my best regards