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19/04/23 Phill Burgess MD FRCS

Intercollegiate Specialty Board Examination

19/04/23 Phill Burgess MD FRCS

“.......and how long is a piece of string?”

19/04/23 Phill Burgess MD FRCS

Section 1

Paper 1: MCQ 2 Hours (single best answer)

Paper 2:MCQ 2 1/2 Hours (extended matching items)

19/04/23 Phill Burgess MD FRCS

Section 1 MCQ

Standard Setting

• Examiners sit and answer the two papers.

• Assess probability of a candidate answering each question correctly.

• Pass mark determined by total sum of probability scores divided by number of Examiners (Angoff Technique).

19/04/23 Phill Burgess MD FRCS

SBA Sample 1

A 27 year old woman presents with diarrhoea and weight loss. This is associated with abdominal distension after meals. What would be the best investigation?

A Barium enemaB Barium enema and follow throughC CT scanD Gastroscopy and biopsy of small bowelE Gastroscopy and biopsy of stomach for helicobacter

Sample 2

Laparoscopic donor nephrectomy is generally considered to be superior to open nephrectomy for which one of the following reasons?

A Reduced incidence of complications in the recipient operationB Reduced intra-operative blood lossC Reduced postoperative analgesic requirementsD Reduced warm ischaemia timeE Shorter operating time • 19/04/23 Phill Burgess MD FRCS

SBA Sample 3

A 70 year old man develops hypotension and sweating with associated abdominal pain seven days post sigmoid colectomy. His temperature is 39°C and WCC 18x109/L. What is the most likely diagnosis?

A Acute pyelonephritisB Anastomotic leakC Leaking aortic aneurysmD Myocardial infarctionE Pulmonary embolus Sample 4

A 42 year old woman presents with a two day history of colicky upper abdominal pain radiating to the back. She has previously been well. On examination she is clinically jaundiced. There is no abdominal mass or tenderness. Ultrasound examination of her abdomen shows multiple stones in the gallbladder. Her bile duct is measured at 10 mm and her intra-hepatic ducts were dilated. What is the most likely diagnosis?

A Bile duct stonesB Biliary dyskinesiaC Carcinoma of the pancreasD Chronic pancreatitisE Primary sclerosing cholangitis

19/04/23 Phill Burgess MD FRCS

EMISample 1 OESOPHAGEAL PATHOLOGY A AchalasiaB Barrett’s oesophagusC Candida oesophagitisD Congenital oesophageal strictureE Eosinophilic oesophagitisF Fibrotic strictureG Mallory Weiss tearH Oesophageal perforationI Oesophageal varicesJ Plummer Vincent syndromeK Post cricoid webL Reflux oesophagitisM Schatski ringN Squamous metaplasiaO Vascular compression of oesophagus

For each of the scenarios below, choose the single most likely diagnosis from the list of options above. Each option may be used once, more than once or not at all.

Is a cause of haematemesis following prolonged retching.A 55 year old woman with long standing rheumatic mitral valve regurgitation suddenly develops dysphagia for chicken pieces.An 80 year old spinster who lives alone develops dysphagia for some solids and is found to be anaemic.

19/04/23 Phill Burgess MD FRCS

EMISample 2 ABDOMINAL MASS A Appendix abscessB Appendix massC Caecal tumourD Diverticular diseaseE Ectopic pregnancyF Fibroid (uterine)G HypernephromaH Ovarian cystI Pancreatic tumourJ Sigmoid volvulusK Terminal ilial mass In each of the following scenarios, choose the most appropriate option from the list above. Each option may be used

once, more than once or not at all.

A 17 year old man has a five day history of lower abdominal pain, nausea and a temperature of 37.8°C. He is tender in the RIF and a mass is palpable.A 28 year old woman has a three day history of RIF pain. She is unable to lie flat. There if a vague mass in the RIF and she has a temperature of 37.2°C.A 57 year old woman is lethargic with a two month history of pain in the lower abdomen. She is pale and there is a palpable mass in the right lower abdomen.

19/04/23 Phill Burgess MD FRCS

Section 2

Clinical Component

“consisting a series of carefully designed and structured interviews on clinical topics, some being scenario based (structured orals) and some being patient based”

19/04/23 Phill Burgess MD FRCS

Standard

Day 1 Consultant

19/04/23 Phill Burgess MD FRCS

Section 2• Held over three days

• Clinical Examination (subspecialty)

• General Surgery/ Subspecialty

• Emergency surgery & Critical care

• Academic Viva

19/04/23 Phill Burgess MD FRCS

Section 2

• Approach the clinical and the oral examinations as if you are a Consultant.

• You are not sitting the examination as a surgical registrar.

• The examiners are your “colleagues” with whom you are discussing cases

19/04/23 Phill Burgess MD FRCS

Intercollegiate Academic Viva

Phillip Burgess

19/04/23 Phill Burgess MD FRCS

Introduction

Two Papers to be discussed

30 minutes reading time per paper

19/04/23 Phill Burgess MD FRCS

Key Points

The Journal

The Authors/Institution

19/04/23 Phill Burgess MD FRCS

Key Points

Aims of the study

Type of Study : Observational?Blinded – Single?

Double?Multicenter?

19/04/23 Phill Burgess MD FRCS

Key PointsMethodology

Statistical AnalysisSample sizePower CalculationVariables

Significance testsparametricnon-parametric

19/04/23 Phill Burgess MD FRCS

Key Points

Data Collection

End points of study

Exclusion criteria

19/04/23 Phill Burgess MD FRCS

Key Points

Results of the Study

Conclusions of the Study

19/04/23 Phill Burgess MD FRCS

Key Points

Have the Aims of the study been addressed?

Are the authors conclusions justified by the results?

19/04/23 Phill Burgess MD FRCS

Key Points

What additional data is required to complete this study?

19/04/23 Phill Burgess MD FRCS

Final Assessment

Will this study influence your clinical practice?

Has this paper made any contribution to surgical knowledge

19/04/23 Phill Burgess MD FRCS

Final Assessment

Give you opinion regarding the merits of the paper.

19/04/23 Phill Burgess MD FRCS

Typical Questions

• Type 1 or Type 2 errors?• Non parametric and parametric tests?• What is a consort diagram?• What is impact factor?• Describe “levels of Evidence”

19/04/23 Phill Burgess MD FRCS

Finally

Maximum of 7 years to complete the examination process.

Section 1: 2 years from 1st attempt and maximum of 4 attempts to gain eligibility to proceed to section 2.

Section 2: Maximum of 4 attempts

19/04/23 Phill Burgess MD FRCS

Practice!!!

19/04/23 Phill Burgess MD FRCS

Any Questions?

19/04/23 Phill Burgess MD FRCS