Saturday, 27 September 2014

The FCEM Management Viva - The Basics

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

  • Delegation

  • Communication Skills

  • Medico-legal awareness

  • Governance

  • Ethics & Probity

  • Managing your staff

  • Recognising educational opportunities

  • Knowledge of complaints and disciplinary procedure

Common Themes

  • Complaints

  • 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:

  1. Important and time dependant – You need to sort out now

  2. Important but not time dependant – You can sort out later

  3. 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

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