Oxford Medical

GP Application: Summary of the Stage 2 application process

GPST PAPER ONE

Professional Dilemmas - Ranking and Multiple Best Answer (MBA) questions (110 Minutes)

The Professional Dilemma or Situational Judgement test is designed to focus on your approach to practising medicine. The paper assesses your understanding of the appropriate behaviour for a doctor in difficult situations, by being presented with a number of scenarios and a list of responses to each scenario to choose from. Some but not all of these are clinical based. This part is designed to allow you to demonstrate your application of key competencies such as:

Empathy & Sensitivity       
Communication Skills
Conceptual Thinking & Problem Solving
Coping with Pressure
Organisation & Planning
Managing Others & Team Involvement
Professional Integrity

 Lasting 110 minutes with an average 50 questions, time to read each question and decide on your answer is tight. It is best to get to know the question format and practise using the correct timings; on average 2 minutes per question. Unless it is otherwise stated in the question your responses should represent appropriate behaviour for an F2 doctor.The paper uses two types of questions Ranking and Multiple Best Answer. Both present you with a scenario, the required answers vary as follows;

Ranking Questions

You are presented with a scenario and also given 5 possible actions to the scenario in question. You then have to rank in order the 5 listed actions in terms of the most, to the least appropriate action to take in response to the situation.

Example Question:

You have set up a new appointment booking system for patients. Patients need to telephone a particular number to confirm a suitable appointment date. They are then allocated a specific appointment time slot. The telephone system is managed by a third party call handling company and is fully automated. Before going live, you phone the number several times to check that the instructions are clear and that the system works. Unfortunately, on the day that the system goes live to the public, your secretary receives a number of verbal complaints from patients about the new automated booking system.

List the most appropriate ways of dealing with this:

1. Contact the call handling company to investigate
2. Contact the complainants to investigate the nature of the complaint
3. Ignore the complaints
4. Implement changes to the system
5. Wait until you have received more complaints before treating seriously

 Answer: 2, 1, 4, 5, 3

 (Theology: Talking to the patients who have verbalized complaints seems the best option and should be first. It could be that there is nothing wrong per se with the new system, rather that people don't like change. On the other hand there could be real problems that have been overlooked eg system not accessible to all. Secondly I'd contact the handling company to see if the patient's complaints can be fed back into the system to make it work better. If needed, changes could then be made to the system early on. Waiting until a critcal mass of complaints is made seems like a poor option, as the system may just need a few simple changes for it to be acceptable to more people. The worst option would be to ignore the complaints altogether, and therefore the patients making them, which would be poor practice and risk certain groups of people no longer attending the practice.)

Multiple Best Answer (MBA) Questions

You are presented with a scenario, followed by a number of possible actions/responses that you could take when faced with the scenario in your workplace. The lists of actions typically consist of seven possibilities and you are also asked to identify the three actions you deem the most appropriate from the list. You do not need to rank in any way these chosen actions, simply identify the three you believe to be the best in response to the scenario given.

Example using the previous question:

You have set up a new appointment booking system for patients. Patients need to telephone a particular number to confirm a suitable appointment date. They are then allocated a specific appointment time slot. The telephone system is managed by a third party call handling company and is fully automated. Before going live, you phone the number several times to check that the instructions are clear and that the system works. Unfortunately, on the day that the system goes live to the public, your secretary receives a number of verbal complaints from patients about the new automated booking system.

List the THREE most appropriate ways of dealing with this:

1. Contact the call handling company to investigate
2. Contact the complainants to investigate the nature of the complaint
3. Ignore the complaints
4. Implement changes to the system
5. Wait until you have received more complaints before treating seriously

Answer: 2, 1, 4

GPST PAPER TWO  

Clinical Problem Solving- Extended Matching Question (EMQ) & Single Best Answer (SBA)

This paper is an assessment of your response in different clinical situations, assessing your use of judgement and problem solving skills to determine appropriate diagnosis and management of patients.

Matching Question (EMQ) and Single Best Answer (SBA) questions are used throughout this paper, and there layout and format and can vary greatly. You are presented with an actual clinical scenario and you will have to choose a response to the scenario from the list of given responses according to your own clinical judgement. As with the previous paper topics are taken from areas with which a Foundation Programme Year 2 doctor would be expected to be familiar.

Example SBA Question:

25 year old woman has a muco-purulent discharge, pelvic pain, cervicitis, urethritis. What is the SINGLE most likely cause of her symptoms?

1. Bacterial Vaginosis
2. Candida Albicans
3. Chlamydia Trachomatis
4. Herpes Simplex
5. Trichomaniansis

GPST Stage Two Scoring

 Applicants receive results for the 2 papers that make up the second stage of the GPST application process shortly after the conclusion of the exams. To progress onto the third stage you must achieve the minimum required standard - score band 2 or above- in both parts of the Stage 2 assessment. Although this the minimum score if you specific deanery is oversubscribed, the higher scoreyou get, the more chance you have of being shortlisted!

2010 data from the NRO demonstrates last year’s scores achieved by GT candidates: