In November 2018 I was approached by the Clinical Director of my local GP Federation, who asked if I would be interested in sitting a Diploma in Urgent Medical Care – a new Diploma run by the Royal College of Surgeons Edinburgh. The Diploma was entirely self-study, with a written and oral exam set over two days in March.
The only revision tool available at the time was the syllabus, due to this being a new exam there were no past papers or practice questions, although there are now sample questions available on the Royal College of Surgeons Edinburgh website. I studied for the exam with a friend, and we met twice with a local GP who had experience in emergency planning and management, had a session on injuries with a local A+E consultant, and we spent a day with the ambulance service in their call centre looking at how ambulance dispatch and the 111 service works. The majority of the revision was otherwise done at home in my own time – at a guess I suspect I spent approximately 100 hours preparing for the exam in total, over four months.
The written exam was challenging – three hours to answer 180 multiple choice questions looking for the single best answer. the questions are designed to evaluate higher levels of leaning, such as clinical reasoning, rather than just knowledge recall. As a result, answering all the questions in the allocated time, requires candidates to pay attention to their progress through the paper. There were a few questions specifically on injuries which I struggled with, as this is outside my normal area of competence.
The following day the oral exam was in the form of 12 OSCE style stations, each with two examiners and a scenario given which the candidate had to talk through what they would do, and wider considerations. General topics included cardiac arrest care, organisation of urgent care centres, management of difficult staff situations as an urgent care lead, management of a head injury, safeguarding of a child following an injury, sepsis and capacity/mental health issues.
Happily I passed the Diploma and was thrilled to do so.
In terms of what I have learnt and how the Diploma has affected my work in Urgent Care I have reflected on the following points
I feel more confident in my role as a Clinical Lead for Urgent Care. Part of my role includes reviewing the work of other GPs, many of whom have been working far longer than me and I now feel I have authority to make suggestions to them about their clinical practice to improve their urgent care work. I also have a part in managing complaints regarding GPs in Urgent Care, and again when discussing with patients about their concerns I now feel I have the qualification to do this, which has given me more confidence.
Dr Lucy Falcus
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