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MRCOG PART 2 SBAs and EMQs

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Answering Essay Questions

Answering Essay Questions Posted by Farrukh G.

 

Answering essay questions

 

We have posted advice on answering essay questions on several occasions within the forum and in the modules. Here is some more, based on recent essays.

 

  1. Answer the question – this is the most obvious first rule but the most difficult to follow.

a) If you are asked to LIST then you must write a list. If you are asked to discuss or describe then you must not write a list or bullet points. The dictionary definition of ‘list’ is: ‘a number of names of persons or things having something in common, written out systematically one beneath or after the other’. So if you write: ‘The criteria for medical management of ectopic pregnancy are: low HCG, no fetal heart, stable woman, hospital protocols and able to comply with follow up’ then you have written a list.

b) You must make it clear to yourself (and the examiner) that you are answering the question.

 

Discuss the advantages and disadvantages

 

Several candidates answered this question without using the words advantage and disadvantage in their answer.

 

The advantages are…. (not a list but a discussion]

The disadvantages are….

 

You were not asked for benefits or risks.  You must answer the question you have been asked.

c) More complex questions will ask you to Evaluate, Justify, Critically appraise, debate. This is not the same as discuss or describe and your answer will not pass if you simply discuss or describe

d) Discuss / describe mean ‘write in detail’. Discuss the history is not the same as ‘state the history’. You will not get marks for writing ‘I will take a detailed menstrual history including LMP…’ unless you explain how this will help you manage the patient.

 

2) Do not use the information in part (b) or (c) of the question in part (a) of your answer. For example:

 

A healthy 34 year old woman presents with a 9 months history of secondary amenorrhoea. (a) Discuss your clinical assessment. (b) She is found to have PCOS. Justify your subsequent management.

 

Part (a) is a broad question about secondary amenorrhoea. If you focus your answer to (a) on PCOS, it will fail. Your answer to part (b) will also fail because you would have written a lot of the information in (a)

 

3) Write an answer plan.

Your plan should be structured. There are only about 10 different types of questions you will be asked and only about 10 correct structures. You then modify this structure depending on the details of the question. For example:

 

A 23 year old woman with Von Recklinhausen’s disease has been referred to the antenatal clinic at 10 weeks gestation. Discuss your antenatal management.

 

You may know nothing about the disease, but

 

Management = Hx, Exam, Ix, treatment, follow-up (+ planning for birth)

Ix in obstetrics = fetal + maternal

 

If the question had provided a lot of history, then there might not be any additional relevant history and you move to Exam, Ix, Rx

 

If you are asked to discuss treatment (options) then your plan has to be:

Conservative

Medical

Surgical

 

If there are no useful conservative / medical treatments then you skip this – there are no marks for saying there are no useful treatments

 

Techniques for different types of questions are covered within the website under Generic Essay Plans

 

4) Your answer must follow a clinically recognizable and logical order. Examination should not come before history for example.

 

5) Your ability to take a general history or perform a general clinical examination is not being tested. You must be able to explain how every item in your answer contributes to managing the clinical problem in question.

6) Keep it simple – no long sentences with multiple subjects and complex structures. This is especially so if English is not your first language

7) Mark your answer plan before writing your essay.

 

Discuss your subsequent management [4 marks]

 

If your answer plan is:

Hx

Exam

Ix

Rx – cons / med / surg

 

Then you are allowing 1 mark (1 sentence) for each of these sections to fill ½ an A4 page. You have probably missed something in the question which should have focused your answer. If you include menstrual hx, sexual hx, obs hx, drug hx in your answer plan for Hx then you have certainly made a mistake. You do not have time / space / marks for all of these. Either this is all unnecessary or there is only one aspect that is needed. By writing all this detail, you will not cover the one relevant aspect in sufficient detail to earn marks.

 

You may also have a situation when you only have 2 points and there are 10 marks. There might be a knowledge issue but usually it is because you have mis-read the question.

 

8) Do not ignore key words / phrases in the question like: healthy, nulliparous, no other symptoms

9) At the start of the paper, make a list of the things you are likely to forget like: MDT, written information / support groups, patient wishes / shared decision, risk management. Check your answer plan to see if any are relevant. Do not just throw them in at the end and hope for a mark.

10) Remember that this is a competitive exam at a number of levels. When an examiner awards 1 mark for a fact + discussion in the first 5 essays they read and then come to your essay where there is no discussion, they cannot justify also giving you 1 mark. There are no ½ marks. So candidates sometimes cannot understand why they wrote menstrual hx, sexual hx… but still got no marks.

11) Remember you are all in the same soup. If a question is difficult, it is difficult for everyone. Your challenge is to score 8-9/20 in your worst essay and 12-14/20 in the other 3 essays. By reading the question carefully, writing a structured answer plan this should be possible.

Thanks Farrukh, I have a query on EMQ Posted by nee P.

 

A healthy 35 year old woman attends for routine cervical smear. Her previous smears were negative. She is found to have mild dyskaryosis. Testing for high risk HPV is negative.

C

Repeat smear in 6 months

 

 

Smear result:

Borderline or mild dyskaryosis

Borderline ? high grade or borderline endocervical cells

  • Perform HPV test. If sample is inadequate or unreliable for HPV test then refer mild and recall borderline for repeat cytology at 6 months.
  • HPV negative: routine 3 (< 50 years old) or 5 (≥ 50 years old) year recall depending on age
  • HPV positive: refer for colposcopy. No repeat cytology

 

Dear Paul/Faruqh

The above EMQ answer in the EMQ bank Oncology,  the correct answer should be routine recall as HPV testing is negative …..but the answer given is repeat smear & it does not match with the explaination. Please clarify.

    Thanks,