Examination Kits for the Clinical Exam

For the short cases & long cases in the Fellowship Exam you need to supply your own examination equipment.  Most people assemble their own “kit” of various implements in a briefcase or other case, and at the last clinical exam in Melbourne where I was assisting, several candidates generously allowed me to photograph their Examination Kits, so you can get an idea of what sort of things people bring to the exam.  So a huge “thankyou” to those of you whose kits I’m showing in this article, this will definitely help future candidates prepare for their exam.

In my mind there are a few characteristics of a good examination kit:

  • Small enough to be easily portable, but big enough to hold all of your equipment
  • Your gear must be easily accessible so that you don’t have to rummage around to find what you’re looking for
  • It must be easy to pack up/close quickly:  in the short cases you move from room to room to see four different patients so any time you waste packing up (apart from looking clumsy to the examiners) is time down the drain that you could otherwise use to score marks
  • Whatever equipmet you put in, you must be able to use confidently and professionally

So here’s a selection of kits from Candidates at the Melbourne 2012.1 Clinical Exam: (Click on the images to enlarge)

1) Samsonite Ultralite 8 Toiletry Bag
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This bag is compact, light and can actually hold everything you’ll need in the clinical exam. 
Pros:

  • Easy to carry with the top handle,
  • Unobtrusive, and easy to set down in a small space
  • Price: $30 makes it one of the cheapest cases

Cons:

  • Not as easy as briefcase for a “full-blown” neuro exam (as your equipment isn’t laid out in front of you)
  • It’s not big enough for a full size tendon hammer, but easily holds a retractable tendon hammer (see below)

 

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2) Ramsay Books Physician Case

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This is also a great case, as it comes pre-loaded with just about evertything you could possibly need in the exam.  Whilst it’s much more expensive, it’s great for those of you who are “one stop shoppers”, as you won’t need to piece together your own kit.  Whilst it doesn’t come with the Welch Allyn ophthalmoscope/otoscope, it has a pre-cut section in the foam insert that will fit it in. If you want to order one you can click on this link and it’ll take you to the Ramsay page (I don’t get a commission for this product).

Pros:

  • Pre-loaded with just about everything you will need.  From coins & dice for testing agnosia, to tape measure, tuning forks and a box of “neuro-tip pins”
  • Easy to order online, and once it arrives you can start using it immediately
  • Still has some spare spaces to put custom equipment

Cons:

  • Price: At $230 its the most expensive option, but it is tax deductible (and you’ll earn this in the first hour of your first locum shift as a Consultant!)
  • Whilst good for the neuro exam, briefcases are still a bit bulky and can be hard to set down in small exam rooms

Here’s a closeup of some of the finer neuro gear that comes in the kit:
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3) Targus Laptop Bag

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This is a great “home-made” kit, easily purchased from Officeworks (or similar).  It has a foam insert that’s been hand-cut to fit the various bits of equipment.  You can get foam blocks from Clark Rubber and use a razor blade, box-cutter or stanley knife to cut out the slots for your gear.  This particular case was a “hand-me-down” to one of the Candidates from Sydney, so it had been “optimised” by a few trips to the exam. 

Pros:

  • Small: easily tucks under the arm for easy exam-day transport
  • Cheap: Depending which model you get, they’re around $40-$70
  • Small kits like this fit in your suitcase easily if you’re going interstate or overseas for the exam

Cons:

  • Making the cutout is pretty fiddly (I know as I did it for my case in the exam) – watch you don’t cut yourself!
  • Time spent driving to Officeworks, Clark Rubber & hardware store (for cutting tool) and then cutting/making foam insert could be better spent studying whilst awaiting delivery of the Ramsay case!

Overall a reasoble “middle of the road” option
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4) Some other random cases

I didn’t get the exact details on these, but you get the idea from the pictures:

Random Toiletry Bag
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This one seemed a bit all over the shop.  Whilst being very compact, easy to carry around and set down, the multitude of compartments means you may end up ferreting around trying to find your hat pin while the seconds tick away.  May work if you’re well-rehearsed, but struck me as a bit hodge-podge.
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If you’re wondering what that “Robert Timms” item is, it’s a coffee bag, for testing Cranial Nerve I (olfactory!).
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Another home-made cutout in a laptop case
This one was another home-made job, but seemed to work quite well.  I think it may have been another Targus case, but I can’t remember.
It had a functional foam cut-out (I think it may be proper camera-case foam), and fit everything inside.IMG_2362

And lastly, for those who have bothered reading this far, here’s a special tip from one of the candidates.  If you have trouble remembering which tuning fork is for which test (vibration sense vs Rinne/Weber), just label them! “A” is for audiology, “V” is for vibration. Simple
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So there you go, a detailed roundup of the various types of examination kits you can use for the clinical exam.  Whilst it seems that the future of this section of the exam is limited, as there are rumors that they’ll be abandoned (and rightly so) in the not too distant future, and replaced with workplace based assessments (groan), hopefully this post will help those of you who still need to get through this notoriously difficult section of the exam.