Prepare for an oral exam

all of the materials are here: https://eflo.medicine.wsu.edu/community/med-clin-533-2025?section=view-folder&id=1953

Oral Presentation (EPA 6)

Transitions & Hand-offs of Care (EPA 8)

Recognition of Urgency & Instability (EPA 10) v Calling for Consultation (EPA 9)

Informed Consent (EPA 11)

https://www.aamc.org/about-us/mission-areas/medical-education/cbme/core-epas

Oral presentation

Preferred format for surgical rounds (surgical one-sentence summary): 

Name, Age, Sex, POD # from X for Y, complicated by Z. Today the patient is XX (vitals, focused exam). Discharge plan is YY (describe anticipated barriers to discharge and follow up plan)

An example of how a student typically presents:

This is a 71-year-old male who was admitted for acute appendicitis and underwent laparoscopic or exploratory laparotomy, revealing a ruptured appendix secondary to acute appendicitis. The removal was completed successfully, and a surgical drain was left in place, connected to bulb suction. The patient was started on IV Zosyn. Post-operatively, he has been doing well, with a return of bowel function, passing gas and stool, and tolerating diet without any concerns. He is anticipated to be discharged later today on oral antibiotics and will be seen in the clinic in about a week for the removal of the drain, which has continued low output

A model example of what the examiners are looking for instead:

Mr/Ms. X is a 71 yo M POD #2 from laparoscopic appendectomy for ruptured appendicitis with (describe extent of purulence – localized / walled-off, or peritonitis?) necessitating intraoperative drain placement near the appendiceal stump and postoperative IV Abx. On exam, his vitals are stable, abdomen soft, wounds clean and drain output clear. He is eating, walking and has been transitioned to oral antibiotics with a resolution of his prior

leukocytosis to X. He’s ready for discharge today after drain care teaching with follow up in a week for drain removal

Consult

ipass chart

ipass handoff

sample verbal handoff

recognition of urgency and instability

Example algorithm:

1. Initial Assessment:

• Vital Signs: Check blood pressure, respiratory rate, oxygen saturation, and temperature. 

• Physical Examination: Assess for signs of distress, pain, bleeding, or infection. Listen to heart and lung sounds. 

• Review Medical History: Look for any history of similar issues, medications, or recent events that could contribute to issue. 

2. Immediate Interventions:

• Ensure Vital Signs
• Suggest Therapeutics 
• Planning for Future (i.e. type and cross for blood transfusion, call the OR to expect reoperation)

3. Diagnostic Work-Up

• Laboratory Tests
• Imaging

4. Management Based on Findings of Work Up
5. Consults / Calls
6. Monitoring and Follow-Up:

• Continuous Monitoring. 

• Reassess Frequently

• Document Findings

Informed consent

PRBA image

PARQ link

How to study for the medical knowledge questions:

Review the surgical anatomy.

Know the most common complications of the procedure you are discussing.

Familiarize yourself with the top diagnostic (how to pare down the ddx) and management tricks for each complication.