There are a few areas in exam study that really cut across all of the ‘traditional’ medical topics that you might spend time studying for and Disability is one of those topics.
Topics such as this can be difficult to study for as there are no defined guidelines and no one source of information relating to how the topic should be studied for and how far in depth. At the Review Course we aim to decrease the uncertainty and let you know what you need to know for success on the exam.
EXAM STUDY TIPS
Think about disability in the exam. Can you list off the ADLs and IADLs from memory? Could you list them on a written exam or inquire about them on a history-taking exam? If you have a patient with dementia, delirium, Parkinson's, driving assessment, a cognitive assessment or an assessment of ability to give consent, could you thoroughly inquire about their activities of daily living?
You can use the common following mnemonics to remember the ADLs and IADLs:
Activities of Daily Living [DEATH]
Dress
Eat
Ambulate
Toilet
Hygiene
Instrumental ADL [SHAFT]
Shop
Housekeeping
Accounting
Food preparation
Transportation
In addition to those, a difficult question to ask is in regards to sexual function and disability due to
disease. It is MUCH more common than you may think: in male patients with diabetes over age 55, the incidence of erectile dysfunction is more than half! It's common, and don't forget - if it’s uncomfortable to ask, it’s a great topic for the exam!
Finally, beyond simply inquiring about disability, are you able to prevent disability? If you can be the candidate that recognizes future or impending disability, you will demonstrate the breadth of your knowledge and also your experience in real life practice.
At The Review Course we have our own list of common preventative management
techniques during our Disability lecture. For those that can’t attend the course, remember to think about HEARING FALLS. In any elderly patient, prevention of a fall through medication change, mobility aids, and changes in the home environment would be an essential part of prevention of disability.
As well don't limit your assessment of disability just to your elderly patients. Did you know that the number one cause of disability claims in the Canadian Military is hearing related? If someone mentions that they work in an area with exposure to loud noises, make sure to inquire about hearing protection.
PEARLS FOR PRACTICE
Paperwork. It is going to be a significant part of your practice. Have you filled out Canadian Revenue Agency forms during residency? Or were you protected from that aspect of practice like I was? Though it may not be considered "high quality learning" it can be useful to ask your preceptor to show you how to fill these forms out at least once. The CRA has a decidedly dry, but informative, video series on the following topics and it is an excellent idea to have a working knowledge of the programs available to your patients.
You can watch videos on:
Reference
http://www.cra-arc.gc.ca/disability/