Good evening (or morning…wherever you are in the World),

I am hoping that you are all well.

Tis the season of exams for some. I have spoken to several international students who have their finals coming up, so wishing you the best of luck if you are one of them.

Here in the UK, the days are short (and cold) and so motivation may be at a record low, but rest assure, we are nearly out the other end and then comes Spring :)

I have recently been working with some candidates on ‘Advanced Care Planning’ and so thought I would bring it you all today.

Advanced Care Planning is a topic I have lots of experience in doing and teaching. This is due to the fact that as a GP, I see lots of elderly patients. It is also a topic that if covered well and in advance, saves a lot of unnecessary panic.

Regarding OSCEs, these stations shows that you are able to be patient centred, compassionate and think ahead - all great qualities.

Advanced Care planning:

Advanced care planning entails the following:

Be patient centred
Focusing on what is important to the patient
Getting family and loved ones involved
Making decisions in the patients best interest
Be sensitive
Help support patients to their decisions

There are three key elements that may be discussed in advance - in particular for a patient just diagnosed with Dementia, whereby they are at risk of not being be able to make a decision later on.

Advanced decision to refuse treatment (ADRT)
Lasting Power of Attorney
Making statements about future needs and wishes

In the OSCE, you should be able to show that you can have sensitive discussions with patients (and relatives) in a mature, logical and respectful manner. Notice how it is not all about medical knowledge or being certain about a diagnosis, but more around the communication of information.

Admittedly, not all of the topics above can be covered in a 8-10 minute OSCE, but being able to approach these discussions, or plant a seed- is all showing a realistic doctor in training.

As per usual, the above is just to get you thinking and not a comprehensive guide.

In addition to the above- when helping patients make decisions, ensure you are checking mental capacity. This is a whole topic by itself!

If you would like to have one to one tutoring around medical topics/OSCES and communication skills, please get in contact.

Take care of yourselves