Medical IELTS

A Workbook for International Doctors and PLAB Candidates

David Sales

• Publisher: CRC Press
• Year: 2020
• ISBN:
  9781351432344
• Edition: 1
• Topic: Medicina
• Subtopic: Medicina interna y diagnóstico

In which occupation are you?' 'From how long have you been smoking?' 'Do you take any alcohol/drinks?' All overseas qualified doctors who apply for registration in the UK must satisfy the General Medical Council that they have the necessary knowledge of English, by obtaining a satisfactory score in the International English Language Testing System (IELTS) examination. This interactive workbook provides a wide range of questions and answers on this subject, containing specific medical sections to address the common problems and pitfalls relating to vocabulary and fluency in everyday medical consultations. Overseas qualified doctors needing to take the IELTS examination in order to be eligible for the GMC PLAB examination, which is required for practice in the UK, will find this book essential for their study.

Part One

1 Communication with patients: general points

Greeting and introduction (see also Module 31: Useful interview expressions and Module 40: Healthcare)

When introducing oneself, the statement Hello/good morning/how do you do? My name is Dr ………. I’m the SHO from the ………. department’ is fine for most occasions.

It is useful to know how best to address a patient and in general it is preferable to err on the side of formality and address patients by their style and surname (second name), but sometimes clarification is justified and in such cases questions asked by an IMG might include:

• ‘How may I address you?’

• ‘How may I call you?’

But ‘Is it alright (OK) to call (address) you by your first name?’ is fine, when appropriate.

Thereafter it is vital for any medical consultation to start well and a number of opening questions might be asked by an IMG, including:

• ‘How are you doing today/this morning?’

• ‘How is your day?’

• ‘How are you feeling today?’

• ‘How are you?’

However, these questions are generally unsatisfactory in a medical consultation as the patient usually has some complaint.

So … it is preferable to ask a question such as follows below:

Presenting problem and addressing patients’ concerns

In a hospital outpatient department the reason for a patient’s attendance may be explicitly (openly) obvious, but in a number of other settings the reason for a patient attending may be less clear and so it is vital to discover the reason for attendance by asking questions such as:

• ‘How can I help you?’ or

• ‘How would you like me to help you?’

either of which will suffice in the majority of instances, followed up when appropriate by a question to encourage the patient’s contribution such as: ‘Could you tell me more about your problem/condition/illness?’

Thereafter, it is important that the doctor obtains sufficient information to exclude any serious pathology by taking a formal and systematic or appropriately focused medical history as described in the following chapters.

Sometimes it’s important to frame the questions, and good examples that might be used by an IMG include:

• ‘Sorry to have to ask you these questions.’

• ‘I understand that you have a problem of a sensitive/personal nature.’

• ‘Is it alright/OK to ask you some personal questions?’ or

• ‘I am sorry, but I hope that you understand that I have to ask these questions.’

Having heard the patient’s story, unless it is already totally obvious, it is usually helpful to enquire what they think their problem might be and an IMG might proceed with a variety of questions to address the patient’s concerns, including:

• ‘May I/can I know/address your concerns/fears?’

• ‘May I know exactly what is your concern/what you are concerned about?’

• ‘What is your complaint?’

• ‘Which is your problem?’

• ‘Have you any complaints to tell me?’

• ‘Would you please tell me why you’re worried?’

• ‘What are your fears?’

• ‘You are having a few apprehensions.’

In general, a better response is elicited if the doctor can integrate the patient’s concern with their presenting symptom with a question style such as ‘Is it the ………. (chest pain etc) that you are worried about or what may be causing it?’

Pain

When patients present with pain, questions that an IMG might ask include:

• ‘Is there any pain in your body?

• ‘Where is it paining you?’

But ‘Do you have any pain?’ works just as well and could be followed up with appropriate questions to discover the site, character, aggravating and relieving factors, associations and radiation.

Patients and doctors may use adjectives (see also Introduction) to describe pain in different ways, so, for example, the word lancinating wouldn’t be used by patients, who may describe such pain as sharp or shooting; or boring (pain) which they might understand as being a dull pain like toothache.

Radiation is another word that has a specific medical meaning but patients may sometimes use the term to describe diffuse or poorly localised pain.

2 History taking

Occupations (jobs) and certificates (sick notes) (see also Module 36: Work and Module 37: Money and finance)

It is invariably helpful to enquire how a medical problem affects a patient’s daily life/lifestyle or work.

Communication

Examples of questions that might be asked by an IMG include:

• ‘In which occupation are you?’

• ‘What work are you doing?’

The questions ‘What is your job/occupation/work?’ or ‘What do you do for a living?’ would normally elicit a straightforward response, but occasionally may require further clarification, as the responses may include being:

• in retail: including a variety of occupations such as being a shop assistant;

• in marketing: including any aspect of sales;

• in IT: (information technology) which may include computer programming or operating;

• in management: at any level;

• in the city: which may include a variety of financial or business occupations such as being an insurance broker;

• in HR: (human resources);

• a civil servant: working for the central government as opposed to local government;

• a carer: who would be involved in looking after a person with a particular need for care.

Specific occupations may be volunteered such a being a joiner or chippy (carpenter), copper or the Old Bill (policeman) and there are a number of other terms that are used by professions when referring to each other that are less likely to be volunteered in the medical context.

Earning money (dosh, bread) may be referred to as being the breadwinner or paying the rent. People may talk of burning the candle at both ends when they are getting up early to go to work/study and then staying up late.

Redundancy would be referred to as being sacked and when workers take retirement they may receive a golden handshake (lump sum) followed by a pension, after which time they are referred to as pensioners.

Being unemployed may be referred to as being on the dole (claiming unemployment benefits) as opposed to being on the sick (incapable of work due to health reasons).

A medical certificate for Department of Social Security (DSS) benefits is known as a sick note or sickness certificate or, in Scotland, a line.

Cigarettes (smoking)

Communication

Questions that might be asked by an IMG include:

• ‘Do you have a habit of s...