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Advice for the Foundation programme application
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Ranking Question

You are the colorectal surgical FY1. Your surgical registrar asks you to consent the patient for a simple incision and drainage of a subcutaneous abscess as he is scrubbed in theatre. You have never performed the procedure before.

Rank in order the following actions in response to this situation (1 = Most appropriate, 5 = Least appropriate)

A. Look the procedure and its risks up on the internet and consent the patient
B. Ask advice from your SHO
C. Call your consultant for advice and find out if it is appropriate for you to consent
D. Explain to the registrar that you are unable to take consent as an FY1 and you have never performed th eprocedure therefore aren't competent to do so
E. Ignore what the registrar has asked until you have finished checking all the bloods on the ward, and then talk to him about the consent process 


Answer: DBCEA

This question assesses your ability to communicate with your colleagues and work within your own limitations. You are an FY1 and have never performed this procedure before, therefore you are unable to take consent. Taking consent involves a discussion of the benefits, side effects and potential complications of the proposed treatment, something you as an F1 would be unable to do. Explaining this to your registrar (D) is the most appropriate response as it demonstrates you understand this, and shows your ability to communicate with your colleagues to ensure patient safety. The least appropriate response is to take the consent (A) as doing so puts a patient at risk as they will not know the risks that they are consenting to. The next most appropriate action after (D) is to ask for advice (B). It is more appropriate in this circumstance to go to your SHO first as going straight to the consultant could involve getting the registrar in trouble, and result in a breakdown of your professional relationship. So (B) is more appropriate than (C), however putting these the other way around would still score 3 marks for each. (E) is the second most inappropriate as it could cause an unsafe delay to this patient's treatment.


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