Advanced Technique - Further History

Most STAMPS & KFPs are predictable, as there are only a limited range of aspects that examiners can ask. This makes preparing for them that little bit easier, so long as you know the rules of the game.

A classic question format takes the format of asking for further history. There is usually a long case, with some aspects of history in, and the lead in asks for further history to either support a likely diagnosis, or perhaps even to exclude a serious cause.

These are easy marks, because taking a good history is our core DNA as doctors. There are however a couple of pitfalls where people lose easy marks.

The first thing to point out is that your further additional aspects of history must be not already be in the stem. Sounds obvious right? But we at PassGP have seen it all before -and this error is right at the top. You need to find some extra history not what already given. So, before you start, find every single clue in the stem – history questions are riddled with them, and use them to narrow down what won’t score.

Easy peasy!

The second thing to point out is that your history must be specific. You need to actually give a symptom and not a descriptor. So, for e.g., ‘shortness of breath’ would score, whereas ‘respiratory symptoms’ would not. BE SPECIFIC! Generalised answers are almost never correct.

Finally, you need to think broad. This might sound like a contradiction to point two, but by broad, we mean using a systems approach to answering these questions. If you give too many respiratory symptoms, you risk being capped because they are too similar. If, however you can mix it up by giving (valid) symptoms from multiple systems e.g., cardiovascular, respiratory, gastroenterological etc., you stand a chance of doing much better.

Rest assured - PassGP we delve into these later in deep depth, with many worked examples and many chief examiner tips.