ThaiUSMLE
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I am IMG and I've never used English in daily conversation for 24 years since I was born (but I learn English in school). I've just started using English 3-4 hrs a day for 3 months(practice cases in FA with my friend and some Native speaker teacher). And I will go to stay in the USA for 1 month before the exam. I will take the exam on 29th Aug.
Do you have any advice to give me to imporve my communication skill?
Counselling skill,too?
((This test is very important for me(for everyone,too)))
Thank you for you all
ThaiUSMLE
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| CSobsessed
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ThaiUSMLE, I am afraid you are mixing up communication skills and English skills.
Do you have a sample of the communication skills checklist which will be filled out by every patient? I do not want to post it before I ask because it is long.
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| danush
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Hi csobsessed, i dont have the sample of the checklist. Can you please post one. Also is there any checklist of interpersonal skills. I would really appriciate if you post one. Thanking you.
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| CSobsessed
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Ok, danush. I think communication skills and interpersonal skills are basicaly the same things... Below kind of the communiction skills check list the SP are given to score doctors. But do not take it literally!!! This what people think on what skills the examinee is scored, not like this is an exact copy or something.
1. Examinee knocked before entering. 2.Appeared professional in dress/grooming hygiene. 3.Introduced self by name. 4.Used patient's name( at least 4-5 times during encounter). 5. Made comfortable eye contact. 6. Focused attention on patient. 7. Conveyed a nonjudgemental attitude. 8.Expressed empathy ( reflected patient's feelings). 9. Used appropriate draping technique. 10.Asked a few open-ended questions. 11. Used non-leading questions. 12. Asked one question at a time. 13. Gave patient time to think and to answer w/o interrupting. 14.Paraphrased infromation throughout encounter. 15. Used lay language ( or volunteered explanation). 16. Used transitional phrases, sentences. 17. Gave explanations( what he is going to do) during physical exam. 18. Made appropriate reassurances. 19. Summarised significant information in closing. 20.Explained diagnostic impression in lay terms. 21. Discussed diagnostic tests. 22.Asked if patient had questions and answered properly. 23. Provided patient education/suggestion ( case spesific). From this you can see why closing is so important: easily 5 out of 23 points lost if one did not do it.
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| CSobsessed
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Sorry, it was suppose to appear as a neat table one point per line. Not my fault. You make it as a table and when you practice with somebody, after each case that person gives you points as would real SP did. That is why the partner for study is so important. He hears you. Whether you are too cold or too pushy or wander walls with your eyes instead of looking at the patient or have never addressed to the patient by his name.
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| danush
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Thanks CSobsessed . One more question . When do we counsel the patient. As an when we get the smoking , alcohol,etc history or at the end before closing.
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| CSobsessed
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danush, I think that couseling is the most doubtful part. Some people on this forum suggest to counsel everybody on every bad habit the person has. I was told( and it was a strategy I used) that couseling must be case specific otherwise it is considered judgemental. It will save you time too . I think such strategy makes sense for the exam. Imagine -The Patient:" Doctor, doctor my head hurts so much and I have a fever, and I can not look at light!!!" - The Doctor:" Year, buddy, I think you have meningitis. But you are bad boy. You smoke! You should quit smoking and I can help you with this." So, you counsel, I think, if the patient's disease directly related to the habit. For example, if you considering cardiovascular problem you do counsel about smoking because it is one of the major risk factors. Or COPD. You know that smoking definitely will make things worse for the patient. Or, for example, you suspect a. pancreatitis. You know that ETOH is one of the two major causes. Of course, you care how much this particular patient drinks. And if he drinks a lot, you ask CAGE questions and counsel him but in this case even if he smokes besides his drinking-- it is not his major problem right now so you do not counsel him about his smoking. If the prostitute smokes and is a drug user and has multiple unprotected sex-- her smoking is your not first line worry, right? So, you counsel her about drugs and condoms and maybe on the shot for hepatitis B because this is the only preventable sexually transmitted disease... When do you counsel? It depends. The patient can bring it himself. For example, acute pancreatitis. You already asked CAGE at your history part. You proceed to PE. Right at the middle of the PE he askes:" Doctor, do you think I feel so bad because of my drinking?" Then you do say something like:" Yes, Mr. Smith, your condition today could be brought by alcohol use." Then you proceed with PE. Then while closing, after you told the patient about the diagnosis and tests you are going to do, you say:"Mr.Smith, as I meantioned a couple of minutes ago, such condition strongly depends on drinking alcohol beverages. I would recommend you cutting down on using alcohol. Please, think about it and when you are ready I will be more than glad to arrange an appointment for you with a counselor in our hospital so he can help you with your reabilitation program." Or, if the patient did not bring it up himself, you just counsel him at the very end after you discussed all diagnosis stuff. At the very, very end you ask him if he has any questions. Remember, it is just imaginary case. I am sure you'll face variations on your exam. Or maybe you will find better words.And as I said before, I used this strategy and I passed. Other people use another strategy and they pass. Just pick the one you like the most, I guess...
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| danush
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Thanks man, you are simply too good
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| ThaiUSMLE
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Thank you very much
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| reet
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thai usmle--- do some non-paid volunteer work in some hospital...then u can learn to communicate with staff 'n' patients..
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| ThaiUSMLE
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Can you tell me where can I find that position?
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| CSobsessed
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reet, it is a wonderful suggestion on its own. But I think that ThaiUSMLE just does not have time to put your idea to life. If I am not mistaken, his exam is in just a little bit more than 1 month. He will not be allowed to take any history from patients in the hospital. He will be allowed to hand out blankets at best and this is not enough for the communication requied at the exam. ThaiUSMLE, do not get distructed from your study. Repeat endlessly with your friend and teacher medically related phrases and questions starting from the introduction yourself through" where is the pain?" and so on and think of possible answers . Once in USA your best bet is to find a study partner whose English is OK . If you are unable to find a potencial study partner on-line so you meet with him/her after you arrive to USA you can try to go to one of the Kaplan Centers. Go to www.kaplan.com and find a location of the center in the city where you will reside while in USA. It is how it works in Washington, DC center. Lots of FMGs there.You place your note with a phone number in the lunch room on the announcement board that you are studying for CS and looking for a study partner. It works. I agree that from now own you should spend much more than 4 hours a day for your English. Hope it helps.
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| ThaiUSMLE
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Thank you very much I will practice English more.
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