Hellooo Friend!
Hema Here!
I thank Dr Chaitra Hodegere, one of the GPs from Yorkshire, who has successfully passed his CSA recently for sharing his top tips to help you in your CSA exam preparation.
Handed over to Chaitra…..
Top things I have learnt from my experience with CSA.
1. Firstly it is not a clinical skills assessment. In fact it anything but. Prepare for it as a communication skill assessment. IMGs have to come out of their doctors shell and reduce the emphasis on knowledge. What all you do is so less important that it does not matter at all. How you do it is the one which counts.
2. Knowledge is still important to boost your confidence. It also gives you options and flexibility to be patient centered. Read about day-to-day stuff on patient.co.uk and cks. NICE guidelines are important but don’t be very rigid about it.
3. The simulators are very important in passing or failing you. The matter more than the examiner who marks you. I have seen the difference in the way the patient acts if they like you. The bias is very evident here. So male IMGs please take that extra step to please them.
4. Dr Una Coales suggested wearing a suit; always keep smiling; go to the door and greet them; offer them a chair before you sit and let them talk till they have nothing to say. The patients seemed more forthcoming than in the past. They did even try to help me in areas where i forgot some tiny details
5. Even the actors are uncomfortable with silence so use it and they will open up a bit more. Never interrupt. They have a script so they can’t overrun unless you ask things which are not relevant. So let them talk.
6. IMGs might have problems with language skills, so common sense suggest use it less. Use a stop clock to see how much u talk in your videos or mock videos. IF LANGUAGE SKILLS IS YOUR PROBLEM THEN USE IT LESS.
7. IMGs tend to defend a lot. watch your videos and see what you do when you are sign posting or if the patient responds in a way which you weren’t expecting. This does take a lot of time and also breaks the flow by long monologues. So defend questions only when they are private/ personal. If the patient gets irritated or is taken aback by any question just say sorry and move on rather than spending time defending why you asked the question in the first place
8. Long sentences are another pitfall of IMGs. IF LANGUAGE SKILLS IS YOUR PROBLEM THEN USE IT LESS. instead of asking long worded questions cut them short. for example. if you have already asked ‘do you smoke?’ instead of asking ‘do you drink alcohol?’ do you take any drugs?’ try do you smoke? after the reply just say ‘alcohol’ ‘ any drugs’.
similarly with symptom check or red flags. do you have any fever? tummy ache? etc don’t make a full sentence every time. It takes less time and sounds less formulaic; this also doesn’t break the flow of the consultation.
9. Structure – sticking to it is difficult without appearing formulaic. but be flexible and write down in a piece of paper and try to cover most of them. Don’t get bog down in asking every patient about smoking, etc.
10. Explanation – try to stick to a simple explanation from patient.co.uk or the ones you have used. all the patient needs to know is a name of the condition. is it common, why has he got it, what can be done about it. Physiology and mechanism are only helpful if that leads to any treatment or lifestyle change. what is the point of explaining about pancreas to a patient with diabetes. You might dig a hole and the patient might help you dig it further if they don’t really like you. so be very precise. let the patient ask for anything more if they want to know. If you offer them they will say yes and it might not be very productive. so be careful
I will add things to and update this page later. These are just my ideas of what helped me. Try to use them in your day-to-day surgeries and make your own mind. If you practice with your own style , you will sound more confident and you will be more comfortable and it helps in a very nervous situation.
All the best for those who are giving the exam in the near future.
Chaitra Hodegere
Hema Again…
Thank you, Chaitra.
Hope those points help you to fine tune your preparation.
Be Creative, Live Your Dreams and Celebrate Your Life NOW!
To Your Success,
Hema xoxo.
General Practitioner.
Creator of Royal Amore & CSA SmartGroup & Ready to Shine
Author of CSA Success Grenade – Fundays.
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