Case SOAP and presentation

[DS-Bruno]

I have searched the forums and have not been able to really find anything current. I have an interview and there is a clinical case portion, they give you the S/O and their SOAP template for you to fill in the A/P portion, and then you present it to them before your panel interview.

Has anyone been through this process that can offer some advice on the best way to handle this?

Obviously we've done cases and SOAP's in school, but I have not done any on APPE's and I have never had to present or defend my submissions like some schools do.

I should mention that my first choice is my first interview, so I'd really like to make the best impression possible.

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[rx25295]

You haven't done any case presentations on APPEs?? My school required us to do SOAPs on all clinical rotations, even if just to turn into our preceptor. I'm a bit surprised that you hadn't done so on any of your rotations and are already this far into the year.

I would review some of your SOAP notes from school, maybe. if you're on a rotation now that would allow for it, pick a patient or two and write up a soap note for practice. Talk to your preceptor and maybe they can help you get some additional practice.

It is a bummer that your first choice is your first interview, to be honest. At least from my experience (and friends I've talked to), the first interview tends to be somewhat awkward because of nerves. Just try to stay calm and focused, and be yourself. I am in the same position this year where I have a first choice program as my first interview, so I feel you.

(And if anyone else is reading this, I would advise to schedule top choice programs later, if you have the ability to!)

 

[lionheart555]

I have searched the forums and have not been able to really find anything current. I have an interview and there is a clinical case portion, they give you the S/O and their SOAP template for you to fill in the A/P portion, and then you present it to them before your panel interview.

Has anyone been through this process that can offer some advice on the best way to handle this?

Obviously we've done cases and SOAP's in school, but I have not done any on APPE's and I have never had to present or defend my submissions like some schools do.

I should mention that my first choice is my first interview, so I'd really like to make the best impression possible.

I think it will be very difficult to give advice not having any idea what you are up against, but here goes

First of all, you should...
- Find out (or post here if you know) additional information about your case presentation. How blind are you going in? Is it a specific disease state or multiple? Can you ask previous or current residents more on the presentation? How much time do you have? That should give you an indication of what to expect.

To prepare
Stay within the time limit. That means structuring your answer in a way that allows you to get all the important parts in.
Don't forget to mention why you chose a specific plan over alternatives (of course don't elaborate too much on the alternatives)
Wherever possible, try to give a distinct recommendation (not "could try drug 1, 2, or 3 - pick one!) and why
Talk about short and long term (if appropriate) monitoring
Mention important objective information but don't list normal items out (For example if all labs look great, pick a few relevant to disease/drug therapy and say they are within normal limits). That will help you save time

But really - I'm not clinical so I don't know anything
It would be much more helpful to you if you gave a bit more information. At least what type of program this is so the more clinical people on the forums can give you some real advice

 

[DS-Bruno]

You haven't done any case presentations on APPEs?? My school required us to do SOAPs on all clinical rotations, even if just to turn into our preceptor. I'm a bit surprised that you hadn't done so on any of your rotations and are already this far into the year.

I would review some of your SOAP notes from school, maybe. if you're on a rotation now that would allow for it, pick a patient or two and write up a soap note for practice. Talk to your preceptor and maybe they can help you get some additional practice.

It is a bummer that your first choice is your first interview, to be honest. At least from my experience (and friends I've talked to), the first interview tends to be somewhat awkward because of nerves. Just try to stay calm and focused, and be yourself. I am in the same position this year where I have a first choice program as my first interview, so I feel you.

(And if anyone else is reading this, I would advise to schedule top choice programs later, if you have the ability to!)

Yes, I know one of the other schools that I have been on rotation with requires their students to submit SOAP notes throughout APPE's, but it's not a requirement for us. After this experience, I honestly wish it was so I could get more experience.

 

[DS-Bruno]

I think it will be very difficult to give advice not having any idea what you are up against, but here goes

First of all, you should...
- Find out (or post here if you know) additional information about your case presentation. How blind are you going in? Is it a specific disease state or multiple? Can you ask previous or current residents more on the presentation? How much time do you have? That should give you an indication of what to expect.

To prepare
Stay within the time limit. That means structuring your answer in a way that allows you to get all the important parts in.
Don't forget to mention why you chose a specific plan over alternatives (of course don't elaborate too much on the alternatives)
Wherever possible, try to give a distinct recommendation (not "could try drug 1, 2, or 3 - pick one!) and why
Talk about short and long term (if appropriate) monitoring
Mention important objective information but don't list normal items out (For example if all labs look great, pick a few relevant to disease/drug therapy and say they are within normal limits). That will help you save time

But really - I'm not clinical so I don't know anything
It would be much more helpful to you if you gave a bit more information. At least what type of program this is so the more clinical people on the forums can give you some real advice

Thank you for your answer, I really appreciate it. I had no info on the case other than we had a time limit to review the case and fill out our SOAP, and then a certain amount of time to present it. No idea on disease state ahead of time.

 

[Cookiecatfromouterspace]

The first interview I have is also my first choice, I did some of my rotations there so I have an Idea of what the case will be like thankfully. I know that for the interview we will get a clinical case. Usually candidates get ~5 to 10 minutes to review the case. In these 10 minutes you need to determine what the patient’s main problem is then the rest of the time we discuss our plan and alternatives. Anyways, I recommend that you refresh on all lab values as sometimes they can be helpful (For example glucose levels, troponins, Normal heparin levels, INR, electrolytes, BNP, etc). Like someone mentioned, it is important to be concise but thorough. If the patient has a PE they want to make sure you know how/why it is a PE instead of pneumonia or something else. They want to know what your treatment recommendations would be so I suggest brushing up on major guidelines as then you would know what the primary treatment would be and can defend your answer with evidence. Depending on the time you have there’s different ways it can go. If you have an hour then you have time to talk about your reasoning as to why you recommended something vs another treatment. However, if you only have 30 minutes then consider just stating the main treatment and letting them ask for alternatives if they so desire. Make sure you check for allergies. Don’t want to say give him a cephalosporin when the case tells you they went into anaphylactic shock last time they got one, so know alternatives to common antibiotics. Also know contraindications, don’t want to recommend something that you can determine is not right from the case itself, don’t recommend the wrong dose of apixaban for a female who weighs 105 lbs and has a SCr of 2.0. Know the main monitoring parameters and make sure you know what to look at to determine if patient is improving. Also, know treatment duration if you can. Most importantly be confident, if you don’t know something then don’t guess. Tell them your thought process. If you don’t know the treatment for something just say that you will check such and such guidelines and get back to them with an answer. If you guess then that gives a negative impression, whos to say you wouldn’t recommend something on rounds that can be detrimental to a patient. Good luck