suziep100 Posted February 23, 2011 Report Share Posted February 23, 2011 Hi all So when you look at the sample type of questions for Calgary's MMI, they give you two articles and ask you to compare/ give my opinions etc... about it. And even though I really hope that the type of essay questions resemble the MMI Verbal type questions, I can't help dreading that the essay questions will incorporate some kind of reading articles and formulate answers based on them I brainstormed the sample question (family doctor treating the obese boy) on U of C's Sample question website, and I am hoping to receive some feedback from many people. The link to the question is http://www.ucalgary.ca/mdprogram/files/mdprogram/2008%20MMI%20Essay%20Station%2010%20-%204.pdf The Question is: What is the optimal treatment and why? P1/P2/P3 = paragraphs P1: the optimal treatment should incorporate the patient's condition as well as the recommendations from the articles. But before formulating any treatments, I belive I should first diagnose the patient's condition So the first things to do: 1. look at family history 2. Run some tests 3. Analyze the result 4. See if there is any correlation between the boy's obesity and the boy's disease 5. If there is, then run more tests like blood pressure, cholesterol level, BMI measurement P2: Once analysis is done, then formulate treatments Treatments can be categorized into short term vs long-term short term = dealing with the disorder itself; drug etc.... P3: long-term = addressing obesity; even if there is no correlation between the patient's disorder and his obesity, doesn't hurt to take preventive measures. As demonstrated in the chart, obesity is one of the main reasons that contributes to patient's health complications for people over 20; and a family doctor, I think it is a good idea to address long-term improvements -talk to the patient about 1) Explain the results of my measurements ( BP, chol level, BMI etc...) 2) explain about the danger of obesity - long-term side effects 3) Ask him about his lifestyle - excercise lots, eat lots of veggies etc... 4) Once get a better idea about his lifestyle, then recommend him to lose weight & remain supportive 5) recommendation: encourage him to join community fitness programs, join sport teams at school, or run around the neighborhood etc..... // tell him to eat celery lots during lunch etc.... 6) As a fam doctor, regularly check up on him and see how he's doing P4: Conclusion Important thing to keep in mind = first diagnose the disease - don't assume that obesity = cause of the disorder Weight sensitive issue for many people = so be sensitive about it but also be more firm about the dangers of being obese. Use of study = not all parts match, take only relevant parts Link to comment Share on other sites More sharing options...
HBP Posted February 25, 2011 Report Share Posted February 25, 2011 Sounds pretty good to me. Link to comment Share on other sites More sharing options...
Broccoli Posted February 25, 2011 Report Share Posted February 25, 2011 I think this question in particular is asking how you would counsel a patient to potentially alter their lifestyle. If this is not due to a health disorder and instead just poor diet and exercise, a large amount of childrens' counselling is actually directed at the caregivers, who often feel more responsibility for the child's health than the child feels. Emphasize that it should be a group effort, and get into the nitty-gritties of what he eats for breakfast/lunch/dinner/snacks. From there, make specific suggestions or 'deals' that improve his diet like he can have one chocolate bar for every 20 servings of veggies. It needs to be personalized feedback, and although its a vague example, emphasize that you will customize the counselling to the patient, by possibly explaining ways in which you will do so. Link to comment Share on other sites More sharing options...
Broccoli Posted February 25, 2011 Report Share Posted February 25, 2011 ^^Otherwise it was solid! Link to comment Share on other sites More sharing options...
Ahhdumb Posted February 27, 2011 Report Share Posted February 27, 2011 Just did this practice one myself, I took 40mins as according to this years essay format (about 7 or 8 to plan and read, the rest to write). Lemme know whatcha think, I think I structured it fairly similarly to your plan. It's not stellar I know but hey whatevs, I pretty much tried to make an essay out of what I would have said had this been a verbal station. Obesity is a disease that is currently affecting countless amounts of Canadians , to the point where almost 50% of our nation has a BMI over 25.0. The seriousness of obesity and being overweight is evident in the harm and damages it does to those with the condition, but it is also evident in the health care system that struggles to treat these people. This being said, obesity is still entirely treatable if the right approach is taken. I will use such an approach to help optimize the care of my current patient, a young teenager whom I will refer to as Alf from now on. It is clear upon first meeting Alf that he does a relatively high BMI, which can put him at serious risk for developing cardiovascular disease, especially if Alf has other risk factors such as physical inactivity. In optimizing Alf’s care, great care must be taken to avoid making Alf feel ashamed, embarrassed or looked down upon as childhood obesity can be very emotionally trying for the patient. To begin an assessment of Alf I would like to first get a sense of the facts about Alf’s life. To do this I would ask him what his average day is like, does he play any sports (would he like to?), what are his hobbies and favourite foods. Once I’ve established this I should be able to identify other cardiovascular risk factors such as physical inactivity, and intake of fruits and vegetables. To get a better understanding of exactly how “at risk” Alf is for cardiovascular disease I would also like to get his blood pressure and cholesterol tested because 5% of children Alf’s age do have elevated cholesterol levels according to Prentice et al 2008. It would also be nice to be able to talk to Alf’s family and get a sense of their views of Alf’s health and their concerns. Because battling obesity isn’t something Alf can do on his own and the support of his family is of utmost importance. To begin Alf’s care I think it would be worthwhile to give him a good understanding of the benefits of living a healthy lifestyle and what it could mean for him. Without trying to strike any fear in Alf I would also try to get the message across that his current lifestyle can lead to problems down the road and it would make him feel a lot better in the long run if we dealt with his issue now. If Alf was comfortable with it, I would like to hold a family meeting to discuss lifestyle changes and ways we can get Alf to a more healthy BMI. During the family meeting I would suggest ways I think we could get some physical activity into Alf’s life based on the ideas and interests he told me during our first interview. If he told me he always had an interest in soccer, I would be supportive and say “Soccer is a great idea Alf, I think you’d make a great player, would you consider giving this a try?”. Hopefully one suggestion will catch Alf’s interest. Also I would like to address the nutrition in family and discuss ways we can improve it, I know of many great nutrition counsellors or even informative websites that could help get the family on track. To conclude the meeting I think it would be worthwhile to construct some form of action plan with the family to give them goals to strive for and more concrete guideline to follow. It would be worthwhile to consider the health and various risk factors among my community as a whole, are there many other people in my practice like Alf? If so, is there something about this community that doesn’t effectively deal with the problem of childhood obesity? If this is the case I would look into ways I could implement a program, such as the NSHHP in my own community. A first step here would be to give the NSSHP a call or set up a meeting to discuss how this program was developed and implemented in their community and if they had any suggestions for developing a program here. Much networking must be done with my fellow colleagues but with enough effort, such a program could be implemented in our own community and we could help prevent more children from acquiring Alf’s condition. Link to comment Share on other sites More sharing options...
medguy5367 Posted February 27, 2011 Report Share Posted February 27, 2011 Lol... I hope you realize that the patient's name is not actually "Alf"... Link to comment Share on other sites More sharing options...
Ahhdumb Posted February 27, 2011 Report Share Posted February 27, 2011 o rly????? Link to comment Share on other sites More sharing options...
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