Top Tips for Unseen Cases
So it's approaching that time of year: Exam Time. It's easy to panic, especially when it comes to tackling those tricky unseen cases. But don't worry, here are my tops tips for a successful unseen case.
General Tips
Think before you speak!
It's easy to get intimidated by the situation and sometimes by the grilling but remember to think before you blab! Take a deep breath, don't be afraid to ask examiners to repeat questions or clarify what they mean and admit if you don't know something - they will move on!
Takes Notes
Simple things to help jog your memory during the presentation and don't be afraid to say this to the patient - 'Ok just give me moment to jot this down'. A lot of the patients are used to it, either they will have seen numerous other students already or they are invited back each year so they know the deal.
Don't get caught up talking to patients
Some of the patients may be lovely but try not to get distracted by talking to them about other things than their mouth! You have limited amount of time and it is easy as you're nervous to get side tracked. Just politely say that you're a bit restricted for time and they'll understand.
Be structured in your presentation
Having a structure to the way you present your patient will really show confidence, clarity and concision! Structure it how you would do an exam, for example:
- Patient age, gender, and main complaint
- History of complaint
- Medical history
- Social/Dental history
- Examination: E/O, I/O, ST, HT, occlusion
- Special investigations and what they show e.g. radiograph reports, vitality tests, biopsies
- Differential Diagnoses
- Proposed treatment plan
Lead the presentation
By having a structured approach as above, you should be the one doing all the talking. Don't get thrown off if any of examiners interrupt you with questions, just jump back into the flow of the presentation and importantly, don't jump straight into the diagnosis - they want the story leading up to it, even if your patient comes right out with 'I've got that Lichen Planus thing' (this is what one of my unseen cases did!)
Don't forget the basics
Importantly medical histories, even if there is nothing of note! I've heard stories of students failing finals as a result of not taking a medical history. Also don't get caught up in the complex treatments. What they are looking for are safe beginners, so it's perfectly acceptable to say you'd refer for a second opinion.
Keep the above tips in mind, here are some examples of some of the common things that come up. If your have placements on consultant clinics, this is where most of the recruitment for finals cases comes from so make use of these clinics!
Restorative:
- Tooth Wear
- Periodontal disease
- Prostheses and their design e.g. dentures, bridge designs
- Complicated medical histories
- Management of teeth with necrotic pulps/failed endodontics
Oral surgery/medicine:
- White lesions e.g. Lichen Planus, Leukoplakia, Candida
- Radiolucencies of the jaws e.g. odontogenic keratocysts, ameloblastoma
- TMJD and other pain disorders e.g. trigeminal neuralgia
- Complications of extractions e.g. OAC, nerve para/anaesthesia
- Trauma e.g. mandibular #, orbital blow outs
- Pemphigus and Pemphigoid
- Oral cancer and dysplasia
Child Dental Health:
- Eruption and calcification dates
- IOTN
- Trauma
- Differential diagnosis of white spots/mottling e.g. flourosis, MIH, AI, DI
- Ectopic canines/submerged teeth/hypodontia/supernumeraries
- Prevention e.g. fluoride guidelines, diet advice etc.
- Balancing and compensating extractions
- Sedation
- Consent/Parent responsibility/Gillick competency/NAI
I hope you've found this post useful! Good luck everyone, if you have any questions or other handy tips please leave them in the comments below!
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