The Management Viva
Total of 35min
There is a structured marking grid with ideal Answers
The pass mark is 60-65%
The aim is to assess:
- Ability to prioritise and time manage
- Decision making
- Communication Skills
- Medico-legal awareness
- Ethics & Probity
- Managing your staff
- Recognising educational opportunities
- Knowledge of complaints and disciplinary procedure
- Doctors with difficulties
- Freedom of information
- Staffing issues
- SUIs /Adverse events
- Policy Declarations from other departments
The In Tray
- 5 minutes Reading time
- 15 minutes viva
- Usually maximum of 9 items
- Consists of your Diary Card, Letters, memos, emails
- The first 5 minutes is the most important make sure you read everything, and sort them in order of priority
- Write post it notes of key bits. You can also write or underline on the exam papers.
- You get marks for talking about everything in the in tray even the fillers
- Diary Card is the most important as it gives details of your department and offers ways to link things in for extra marks
- Keep it in front of you
Starting the Viva
- Check the department first – if it is melt down then everything else waits.
- Do I have a clinic or a ward round?
- Can a middle-grade start it?
- What meetings do I have? When are they? Who will be there?
- Do they tie into anything in my box?
Structure of answers
- Have structure to your answers. The following headings might help.
- Always talk about information gathering and how you going to do that. (Patient’s notes, statement from staff, CCTV, IT records, etc)
- Patient issues – Is the patient safe now? Was the treatment/management appropriate?
- Staffing issues – Are there any staff member affected and how? Don’t forget about the pastoral care.
- Short term solutions – Junior doctor teaching session, removing sharps and putting appropriate sharp bins, etc.
- Long term solutions – Making formal policy or pathway.
Prioritising your In Tray
Three levels of priority:
- Important and time dependant – You need to sort out now
- Important but not time dependant – You can sort out later
- Neither important nor time dependant
Tell the examiners how you have done this.
Marking and Scoring Well
- Remember that it is a fixed scheme with ideal answers, every piece in your in- tray carries marks, but value varies (2-12)
- Spend more time on complicated ones
- Score higher by finding the tie ups to diary and other items in the In-Tray
- Be decisive – don’t sit on the fence
- Mention the links and tie ins
- “I’d like to check on the patient”
- Delegate appropriately
- Secure copies of notes and documents
- Take minutes of important meetings
- Empathise with the situation
- Address the issues
- Use guidelines
- Know the organisations who can help – CQC, NPSA, NCAS etc
- Know the processes at your trust – download and read your policies
The common pitfalls are:
Sounding like you have just learnt off the answer
Not touching on all parts of the in-tray
Not moving on in a timely manner
Arguing with the examiners
The Long Case
- More difficult to predict
- Complex multifaceted case
- Once you look up from reading it they will start quizzing you
On the day of the Vivas
- Dress if going for an interview.
- Lots of hanging about on this day.
- Be calm.
- Time is short, so make good use of it
- Read all the papers and have something to say about each of them
- If the examiners try to move you on then let them
- Don’t look up from the long case until you have read it all
- Don’t get aggressive.
- Be polite
With input from London FCEM Course
The FCEM Management Viva - The Basics