Clinical Examinations

You will soon hear many times, how >80% of diagnosis comes from the patients history. This is true, but examination of the patient plays an important part in confirmation or challenging the diagnosis suggested. And perhaps more importantly, examination of systems forms the basis for a proportion of finals, and post graduate exams. Therefore, it is very important to get into the habit of examining patients regularly. Some suggest that you should aim to examine at least one patient a day, and this may sound a simple task, but when lectures, assignments and other specialty activities distract, it is surprisingly hard to achieve this goal. However, I would strongly recommend making it a priority to examine as many patients as possible during your early clinical years. This will make revising for finals much simpler!

The main examinations to master are:

  1. Cardiovascular examination
  2. Respiratory examination
  3. Gastrointestinal examination
    • Useful student BMJ article on stomas
  4. Peripheral nervous system examination
  5. Cranial nerve examination

These examinations form the basis for much that is required in every day practice, and will certainly be examined in finals. There are many different opinions on how exactly to approach the examinations, and a suggested routine can be found by clicking on the links above.

Other examinations that should be mastered for finals include:

  1. Endocrinology: acromegaly, cushings
  2. Peripheral vascular disease
  3. Varicose veins
    • Link to student BMJ article on varicose vein examination
  4. Hernia examination
    • Powerpoint presentation on hernia examination
  5. Neck lump examination
  6. Orthopaedic knee examination
  7. Orthopaedic hip examination
  8. Orthopaedic Shoulder examination
  9. Rheumatological hand examination
  10. Dermatological examination

These too should be practised throughout the course – on patients, colleagues and cuddly toys!

The best sources to assist with learning the examination schemes includes:

  • Past university mark schemes – shows you exactly what will be expected!
  • Macleods Clinical examination – Douglas, Nicol, Robertson
  • Clincial examination: a systematic guide to physical diagnosis – Talley and O’Connor