By London Deanery | September 24, 2018
In recent years concerns have been raised about missed unmet physical health care in mental health patients. Some trainees have shown difficulties in performing physical examination in membership CASC examinations. It is important that any difficulties are identified early by this assessment and that trainees continue to retain skills in physical healthcare and examination whilst practicing as psychiatrists.
Physical examination is an important part of a psychiatric assessment. It allows doctors to exclude organic causes; identify and manage any co-morbid physical illness and monitor any side-effects from psychotropic medication.
All newly admitted patients to a mental health unit should have a full physical examination, which must be documented in the notes.
To demonstrate this competency you will be asked to perform a physical examination: this should be a systematic physical examination as would be appropriate for any new inpatient admission to a hospital.
You should then be able to give a clear summary of the physical examination and may include any other information needed to complete assessment e.g. ** temperature, weight, physical observations, MEWS2 Score**
To demonstrate this competency to perform a physical examination you need to be able to:
- Clearly explain to patient what you are going to do and give clear and readily understandable instructions when appropriate.
- At a very ** minimum** this should include:
- General observation of patient – including ‘end of the bed’, examination of hands and face
- Be able to measure pulse, blood pressure and respiratory rate
- Appropriate examination of the cardiac and respiratory systems
- Appropriate examination of abdomen
- Examination of cranial nerves and peripheral nervous system
- You may be asked to do fundoscopy
Form to sign off the Competency
Note: You can either fill this PDF form on a computer (preferably together with your assessor) and print it out for the assessor to sign, or you can just print the page and fill it out by hand together with the assessor. In any case after the form is signed, you will need to scan it to upload to your portfolio, just like you would with any paper-based evidence form. If you fill the form on your computer you need to SAVE it with a different name - so that the text you typed into the form gets preserved. A form filled on a computer probably, will be easier to read.
If the form opens directly in your browser you probably will not be able to type in the form fields - for that you need to open the form with your system PDF viewer - which likely will be Adobe Reader.