MENOPAUSE MAKES ME CRAZY IN CSA EXAM!

Hellooo Friend!!!

Hema Here!
Give me a Bigggg Hi 5!

Have You Ever Thought that Menopause makes You Crazy?
You are not Alone!


Menopause Makes Everybody Crazy !

Poor Patients!

 

I love to share with you all about 'Menopause'.

Recently, I heard one of my Male colleagues saying, 

'Judi Denches would haunt him asking for HRT in his dreams' (or should I say Nightmares).

Feels scary to cover Menopause in 10 minutes in CSA!
It is difficult to cover all the relevant issues if not prepared WELL in advance.

That is why we should have our Laser Targeted Questions ready!

Ideally A Case might be for the following reasons...

1. Just for the reassurance.(Need to rule out depression etc)

2. For Self Help advice.

3. For HRT.

4. For Non Hormonal managements.

5. For advice on Alternative/Complimentary methods.

What Else?

 
It is important NOT to guess the nub of the case.

We need to Shut up and Listen to the patient till we get their agenda.

(You know me, right? First bit is difficult for me :-)

Then Proceed with the Flow.

Have a Patient Centred/ Led Approach!

It is important  -

To empathise when the patients express their struggle with the symptoms as we do in our normal surgery!

It is very easy -

To get Doctor /Exam centred if we started to work up a step ahead in our Mind.

 
Live that moment!

Feel Light!

Relax!

It is Easier this Way!

Chat as if You Do with Your Friend.

Be Real!


Ten Points to Cover


1. What are the patients' ICE?

2. What is the EFFECT on her?

3. What she KNOWS about the options?

4. Is HRT suitable for her?(our agenda!)

5. If Suitable, Has she still got her uterus or not?

6. If not suitable, what Else can we offer?

7. How can we Explain HRT/ Alternatives?

8. How to incorporate the Life styles changes?

(That is why we need to explore about Smoking, Alcohol, Caffeine, Diet, Exercise etc)

9. How to share our Difficulty in suggesting Herbal remedies?

10. How to Safety net / Follow up  - when prescribed HRT or not?

BNF - Our Best Friend

HRT is one of the pages we should definitely put the colourful tag in our BNF!
( Mine had all the rainbow colours, looked vibrant on the table during the CSA!)

 
Practise How to Share the Risks AND to be Neutral.

Empower Patients to take the Informed Decision!

More Points to Remember :-)

Age, Hysterectomy,

Migraine, Breast cancer,

Stroke, VTE, Smoking,

BP, BMI. (Feel free to add...)

 
If it is your weakest link,

Do as Many Times as Possible and Get Comfortable!

Practise, Practise, Practise!

Till You GetThem RIGHT.

 
Get more golden nuggets from

1. http://www.patient.co.uk/doctor/Menopause-and-its-Management.htm.  (My all time favourite!)


2.http://www.nhs.uk/Conditions/Menopause/Pages/Treatment.aspx 


3. http://www.womenshealth.gov/publications/our-publications/fact-sheet/menopause-treatment.cfm


4. www.menopausematters.co.uk, 

5. Of course, our BNF etc.



It is Easy - Peasy! Lemon - Squeezy!!

Keep interacting!!!     

You are not Alone....

To Your Success,

Hema xoxo.


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EUI FOR CSA EXAM?

Hellooo Frienddd!

Hema Here!

Give me a Bigggg Hi 5!!!

I am thinking! about the correct mindset to have for passing CSA :-)

What I learnt from my Personal experience?

You need 2Ps -

Both of the Ps -  Strong Psychological and Physical fitness on the BIG day of CSA.

Otherwise, It would cost you a lot.

The Correct Mindset for CSA involves E.U.I....

I can hear you wondering  - What is thattt?

E - Education - Realising that You have to learn New skills and to unlearn the wrong ones :-)

U - Understanding - Making sure you understand WHAT you are doing!

I - Implementation - Taking ACTION and Implementing your New Skills - Most trickyyy Bit!

Please Have a Daily Plan -  To make it easy to stick to!

Please Enjoy your Weekends!(unless on OOH)

Hooray!!!

Have a Every Day Plan  

Concentrate on ONE small thing like exploring Ideas or Concerns or Expectations and stick with it in all patients on that day.

Not all at a same time :-)

Finally -  

You will be doing All in <10 minutes.

(where is the stop-watch?)

Believe me!

Wowww!

Observe your Trainer, other GPs, Colleagues to see how they deal it with superb efficiency and Above all, Naturally...

The MOST important thing is to Take Action EVERY day!

The most valuable lessons of all are the ones You teach Yourself.

It takes a PASSION to face a New CHALLENGE.

Remember -  It is a Marathon, Not a Sprinter :-)

This isn't kindergarten where you will get a Gold star just for showing up!

The Key to Success - is  Taking Consistent Action!

At the End of the GP Training - 

Everything. YES...

Everything will be Easy -Peasy!!!

You will be another little Roger Neighbour or Liz Moulton!

( I almost wrote Roger Moore!)

Your Patients Will Love You Forever!

To Your Success,
Hema xoxo.



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WILL YOU KISS IN THE CSA EXAM?

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Hema Here!


Give me a biggg Hi 5 !


KISS...KISS...KISS...

If you are thinking about something physical Here....
Hi Friend, I would say You have got a very good imagination and need a holiday!

Remember... We are in CSA Preparation Blog...

No Time to even Stand and Stare!

I am going to Tell you What Happened in my Surgery recently...Aware of confidentiality :-)

One of my patients recently told me that he would kiss me if allowed (hope not :-) when he came for a medication review.

As I took time to get the histology report from our hospital ICE page and told him the biopsy tissue was a harmless thing, NOT Cancer!

He was totally elated...
It had taken the HUGE burden off his heart.

He would be dreading about cancer for weeks before he got to see the surgeons.

Now he can enjoy the fantastic sunshine!
Temperature is 26- 27 degrees  this weekend!

Just finished some gardening. Clematis blossoms are sooo beautiful...


All that EXTRA effort is very rewarding, Isn't it? 


NOW Seriously,
I am not talking about THAT kind of KISS....
Yes, You might be shouting now -

''Hema, I know all about it-  It is - KEEP IT SIMPLE STUPID''.
Hooray!!!  You are right!


YOU are very Smart! (Big Hi 5 again!)

I would say - Keep It Simple Smart!

It is ALL about keeping our Explanations bit Simple.
During our Practice, one of my friends called Chaitra always used to tell me - 'LESS IS MORE'.

You know me by now, right?
That is very DIFFICULT for me. (You can see from my blog).
I would try to Make my Poor Patients 'EXPERT' about their Problems.
That too in TEN minutes.
How annoying it would be!

That is not at all necessary.

The Secret Keys are to....

1. Ask what they KNOW already?

(Our programme director told us about asking a patient if she knew about virus. She replied back that she was a VIROLOGIST!) Is the spelling correct?

2. What they WANT to know?

When I started GP post,

I was explaining all about NSAIDS for OA but the patient simply wanted to try Physio!!!

(How silly me!)

3. How MUCH they want/need to know?

I always struggle here-
Just need to Ask them to make it Easier.
Tailor the explanation according to the patients' individual needs.

That brings in the importance of finding out their ideas, concerns and expectations!
Now I remember seeing a great Secret on my HSBC relationship officer's mouse pad.
I am sharing it just with you....It is our little secret! :-)
That Secret MANTRA is...

''LISTEN, UNDERSTAND, DELIVER''.
If it works for them, Definitely, IT will work for us too.
I am sure it will save lots and lots of time, energy, etc, etc.( feel free to add whatever suits you).



The Best Thing we can do for ourselves is to Keep it Simple.

Keep it to the bare minimum to start with.

The important thing is to consistently practise them.
So it becomes our HABIT!  
Consistent Practice makes Actions into Habits!
We will certainly look and feel more confident! Wowww!
Good luck with your practice!

To Your Success,

Hema xoxo.


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EMBRACE THE CHANGE FOR CSA EXAM!

Hellooo Friend!!!

Hema Here!

Give me a Biggg Hi5!


Are you really ready for the 'CHANGE'?


Let me ask you something...


Have you heard the expression ?

''If you do what you've always done, you will get what you've always got?

If You have been Waiting for a Change,

But Not Doing Anything Different or Applying New Habits,

Then Might be....

Why You are Getting What You have Always Got.

''We must all suffer from one of Two Pains:

The Pain of Discipline or the Pain of Regret.

The difference is discipline weighs ounces while regret weighs tons''

- Jim Rohn.

Here is a chance to do it differently, to learn how to do it

better and to BECOME someone who is SUCCESSFUL.

This is the right time - CSA time.

The Choice is Yours!

Choice is YOURS...

Start working in the Right direction as Early as Possible in your GP career.

Find out What is Wrong...

Feel Free to Pester your Colleagues, Trainers, Programme Directors to learn the Right Way.

Ask them to Show/Roleplay if you are not sure.

Have lots and lots of practice, video sessions, shared surgery... list is limitless.

Find a way/words you are comfortable with!


Make a TO DO List.

Think about your Attitude! your Mindset!

They Play a Strong Part in Your Success.

Don't be Alone.

Form a Practice Group, the Smart Group :-)

Learn from Each Other.

Be Your Own Worst Critic!

Be the CHANGE you want to SEE.

Keep interacting!

To Your Success,

Hema xoxo.

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HOW TO LEARN FOR CSA EXAM?

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Hema Here!


Give me a Big Hi 5!

DOMAINS (NOT DEMONS!) OF LEARNING NEEDS

If you are reading this blog, I am sure that you really, really want to take a BIG leap in improving your learning pattern to meet your individual needs.



Most People in life are 'Say-ers'.

But, You have proved yourself to be a 'Do-er'.

That is Rare!

You should be Proud!


Start Planning for CSA as Early as Possible.

Sooner is Better!

Domains of Learning Needs-


In simple terms, they fall into Knowledge, Skills and Attitudes!


KSA  for our  CSA!    

Hooray!!!


Knowledge is Easy - Peasy.

Remember, we have already passed our AKT :-)

What about the Skills?

To whom I am talking with? 

You are the Best with your Practical Skills!

But in CSA mode???

It is ENTIRELY different!

This is going to be your Best Friend!

Our Super friend - Skill has three magical wands to help us!

1. Cognitive wand - 

To think about what we are Doing.

2. Fixative wand -

To get it right by mere Practice.

3. Autonomous wand -

To go on Auto-Pilot mode. Wowww!

Intention becomes Action- Action becomes Habit.



Next comes the Attitude!

What do you think about it?

Is it easy to upgrade IT ?

(I wish Steve Jobs had an App for it)

I LUV STEVE JOBS!! DON`T YOU?

I think....

Attitude is the trickiest bit to get it right!

This should come from Within.

It Explores Values, Honesty, Safety of Patients and Attitudes.

Be brave in CSA in similar scenarios to stand for your beliefs.

Like unrealistic expectations, sick note demands, under -performing colleague,etc. 

Try to explain WITH the Genuine reasons.
Finally think about our Facade and Blind spots!

( I am not talking about driving lessons here)

Facade -  what we know that we do not know (Easy bit!).

Blind spot -  what others know that we do not know(Scary!).

In addition to exploring our lovely Patients' Ideas, Concerns and Expectations,

Now - we are going to explore our OWN Facade and Blind spots!

Once you know, WHAT You Want, 

Everything is Easy- Peasy!!   Lemon- Squeezy!! 

Just Go and Get them!

Wowww!! Give me a Bigggg Hi5 again!!!!

Keep interacting!

To Your Success,

Hema xoxo.

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THE CSA AND THE IMG CONUNDRUM?

Hellooo Friend!!!

Hema Here!
Give me a Hi 5 now!!!

Here again, Dr Kashif Bhatti is sharing his thoughts about the CSA preparation specially for you all :-)

He is one of the TOPPERS in our Beautiful Great Yorkshire Deanery in the February 2012 CSA Batch.

Handed over to Kash...Kash..Kash...

The IMG Conundrum???

We all know the pass marks of local graduates versus International Medical Graduates –

But is this an over-simplification?

Whatever the politics of disseminating these figures to GP trainees ONCE they enter training, the fact remains that the high failure rate (in comparison to local graduates) is a massive Negative barrier to SUCCESS.

Yet, IMGs do pass, and Locals do fail.

There are no analytical statistics on these candidates.

A more interesting question is what is the pass-mark of candidates, graduated from the UK, post FY1-2 only, versus doctors from previous specialty backgrounds, regardless of country of graduation or employment.

I postulate, until the RCGP tells me otherwise (updates soon!), that the former have a higher pass mark than the latter.  

Do you think an IMG, long-in-the-tooth, has less experience or wisdom than a fresh-out-of-FY2-local candidate?

My inference of the situation is that IMGs are good consulters/communicators.

After all, the RCGP tells us it is not about usage of English that fails IMG – but are going about it in the wrong way versus lesser-experienced local graduates.

From personal experience, I feel no difference in what I can achieve in 10 minutes between my new-into-ST3 consultation style versus my optimal-for-the-CSA-and-forever consultation style.

The difference is HOW I gather the information and communicate with my patient. 

Yes, some IMGs are not up to scratch, from a doctor point - of- view, but so are some local graduates.

This is common sense - different specialties require different information and how to acquire this.

The same is in General Practice.

So what does this mean for IMGs?

We should remember firstly that statistics are only that – numbers on a page.

The high failure rate to me suggests lack of adaptation – little else.

This is fundamentally positive news for any IMG!

You CAN pass, You ARE good enough!

You possess ALL the tools anyone else has.

You just do not know how to CHANNEL this.

Let go of your reservations and watch videos of good consulters versus your own!

It is NOT YOU that needs adaptation;

IT is your Behaviour! 

Watch your Behaviour!

Become Positive and Interested.

Show Empathy and Place yourself in your Patient’s Shoes.

The medicine will come through.

You have so much more experience than the local graduates in this regard.

Be Positive, Smile, Enjoy!

Kash.

Dr Kashif Bhatti.



Now, It's Meeee...

Wowww Kash!!  What a thought provoking article!

Thank You, Kash.

Keep interacting!

You are not alone!....

To Your Success,

Hema xoxo.

P.S

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I'd love to hear from you!

THE CSA EXAM IS ALL ABOUT POSITIVITY!

Hellooo Friend!!!!

Hema Here!
Give me a Hi 5 first!

I am delighted!!!

I have got a Guest Blogger for You Today!

This blog was written specially for you all by Dr Kashif Bhatti, my great friend, wonderful colleague, fellow trainee who supported us during our CSA preparation.

He is one of the TOPPERS in February 2012 Batch from DWP GP programme.

He is writing about how he feels about CSA preparation.
Handed over to Kash...Kash...Kash...



THE CSA IS ALL ABOUT POSITIVITY !

The CSA examination has a daunting reputation.

It has a perceived unacceptably high failure rate for International Medical Graduates.

We are constantly and consistently informed that 'white females are virtually guaranteed to pass with just showing up on the day'.

It is nearly £1500, which works out to be nearly £10 a minute!

The exam is every few months, so failure is not only costly, it is lengthy too.

In some deaneries, trainees whom pass separate from those who fail, increasing the negative aura of failure.

Finally, we consult for 18 months in General Practice!

How can we fail on the working basic communication we practise everyday?????

Are YOU still searching?????

All of these put up an artificial barrier that we have to climb before we even begin getting to grips with passing the exam.

For some, this becomes insurmountable and they spiral into negativity and repeat failure.

The Key to passing the CSA is POSITIVITY!

We learn much better when we want to learn about something rather than when we are made to learn.

Think about Yourself. 

You will realise you remember what interests you more than what you have to know and which means less to you.

The CSA exam will be the most interesting surgery of your life!

You will have 13 Unique Patients! 

You will never have to worry about their previous health or the future follow up. 

There will be no one with run - of - the - mill problems.

No clinic full of URTI/Stress/Depression/Cough.

(Feel free to add whatever heart - sink situation of your choice!)

THINK POSITIVELY!

For £10 a minute, Enjoy each Moment.

Think of it as a Amusement Park Ride!  Woo-hoo!

You are privileged to have this experience.

You are going to meet the 13 most important people of your career.

Be Interested, Be Inquisitive, Be Positive.

With Positivity will come Interest.

With Interest will come Ease and Relaxation.

With that your natural abilities that made you a DOCTOR will come through.

Your consultation will become natural and flexible rather than forced and pedantically structured.

Trick for you all!! Try it!!

This is the difference between the stressed and panicky IMG who cannot comprehend where their technically sound consultations are going wrong versus the vigilant but ultimately quietly confident local graduate who subconsciously is Positive.

Be Positive, Smile, Enjoy!
Kash.

Dr Kashif Bhatti.



Now,

It's Meeee...

Wowww Kash!! What a Wonderful Article!

Thank You, Kash.

Keep Interacting!

You are not alone!..

Be the first to receive the FREE life changing updates, Tips from Toppers and to be Successful Registrars!

To Your Success,

Hema xoxo.


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