How to Pass the ACEM Fellowship Exam 2015 and beyond

ACEM trainees and fellows will be aware that the ACEM Fellowship exam (FEx) is changing in 2015. The reasons behind these changes have been and continue to be discussed in other forums so I’ll try not to harp on it too much. However, the decision has been made and we will have a new fellowship exam in 12 months time. The new format of the exam will be divided into 2 discrete assessments, a FEx Written and FEx Clinical.  Eligibility to sit each section of the exam has been outlined by the college and can be found within the depths of the ACEM website. For current trainees, a flowchart outlining the transition arrangements is available The changes to the exam are being made with the intention of making it more relevant, more objective and more fair. The college has said that new format exam will focus more on the content of knowledge and skills rather than technique and that candidates should therefore prepare themselves by focusing on attaining consultant level knowledge and skills. Good idea. The point has also been raised that with the pass mark for the exam being in the order of 50-60% that candidates may as well toss a coin, that it’s a random process. Heads or tails. Pass or fail. Personally I think this is complete nonsense. I do accept that the pass mark for the exam is lower than ideal. There are a number of reasons for this, some known and some unknown, but randomness is not one of them. I hope that ACEM doesn’t believe that the candidates ...
Source: Life in the Fast Lane - Category: Emergency Medicine Doctors Authors: Tags: Education Emergency Medicine Exam FACEM II Featured FACEM exam tips Fellowship Examination Source Type: blogs

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Publication date: September 2019Source: Urology Case Reports, Volume 26Author(s): Dilip Kumar Mishra, Vinothkumar Rajenthiran, Talamanchi Vinod kumar reddy, Madhu Sudan AgarwalAbstractParaphimosis is usually acute painful condition. Delay in medical attention might result in dreaded complications like gangrene and auto-amputation. Very rarely patient might present late with large painless paraphimosis as in our case just because it interrupts intromission despite satisfactory painless erection.
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
We report here a huge ADPKD case of kidney transplantation concomitant with simple nephrectomy through thoracoabdominal approach that allows surgeons to manipulate the renal vessels, the adrenal grand, the trigonal ligament, and the lower pole of the kidney under the wide operative field. Because of the direct recognition of the surgical anatomy, it might be safe and feasible for simple nephrectomy in huge ADPKD patients undergoing concomitant kidney transplantation despite of the wide skin incision required by this approach.
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 16 May 2019Source: Urology Case ReportsAuthor(s): Sawkar Vijay Pramod, Sri Suryanti, Zola WijayantiAbstractThis is the first recorded case of urinary tract villous adenoma in Indonesia. A 70-years-old man suffered from a painful left flank mass and jelly like mixed urine. He had undergone percutaneous nephrostomy yielding a jelly like substance, and a previous stone surgery. Left nephrectomy and lymph nodes dissection were performed. Intraoperative finding showed significant mucus fluxed from this enlarged kidney. Histopathological examination revealed columnar epithelium and goblet cells...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
Publication date: Available online 20 July 2019Source: European UrologyAuthor(s): Elise De Bleser, Barbara Alicja Jereczek-Fossa, David Pasquier, Thomas Zilli, Nicholas Van As, Shankar Siva, Andrei Fodor, Piet Dirix, Alfonso Gomez-Iturriaga, Fabio Trippa, Beatrice Detti, Gianluca Ingrosso, Luca Triggiani, Alessio Bruni, Filippo Alongi, Dries Reynders, Gert De Meerleer, Alessia Surgo, Kaoutar Loukili, Raymond MiralbellAbstractBackgroundStereotactic body radiotherapy (SBRT) and elective nodal radiotherapy (ENRT) are being investigated as metastasis-directed treatments in oligorecurrent prostate cancer (PC); however, comparat...
Source: European Urology - Category: Urology & Nephrology Source Type: research
Publication date: Available online 20 July 2019Source: European UrologyAuthor(s): Chen Cheng, Sunxiang Ma, Yang Liu
Source: European Urology - Category: Urology & Nephrology Source Type: research
ConclusionsIP cefepime monotherapy was noninferior to conventional combination therapy for resolution of CAPD-associated peritonitis at day 10 and may be a reasonable alternative first-line treatment.FundingThis study is supported by The Kidney Foundation of Thailand (R5879), Thailand; Rachadaphiseksompotch Fund (RA56/006) and Rachadaphicseksompotch Endorsement Fund (CU-GRS_61_06_30_01), Chulalongkorn University, Thailand; National Research Council of Thailand (156/2560), Thailand; and Thailand Research Foundation (IRG5780017), Thailand.Trial RegistrationRegistered at ClinicalTrials.gov with study number NCT02872038.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Publication date: Available online 19 July 2019Source: American Journal of Kidney DiseasesAuthor(s): Jonathan J. Hogan, Miriam Priya Alexander, Nelson LeungDysproteinemic kidney diseases occur when B- or plasma cell clones produce pathogenic monoclonal immunoglobulins or light chains that cause kidney damage. The clinical presentation of these disorders ranges from sub–nephrotic-range proteinuria or microscopic hematuria with preserved kidney function to severe nephrotic syndrome to severe acute kidney injury or rapidly progressive glomerulonephritis. These monoclonal immunoglobulins can cause a variety of histologic...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
ConclusionsRemission of type 2 diabetes 5 years after bariatric surgery was associated with improvements in albuminuria and stabilized prognostic risk for CKD, but not with eGFR. Lower kidney function and greater prognostic risk at the time of bariatric surgery was linked to a lower likelihood of diabetes remission. These results highlight the need to identify the mechanisms through which bariatric surgery may delay the long-term progression of CKD in type 2 diabetes.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Conclusions: This study highlights the need for more research and interventions for one of the fastest growing subgroups within the TBI population. PMID: 31322004 [PubMed - as supplied by publisher]
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
Authors: Tham SW, Aaron RV, Palermo TM Abstract Objective: To investigate the trajectory of sleep deficiency after concussion and examine its role as a predictor of postconcussive symptoms (PCS) over 3 weeks and at 3 months post-concussion. Design: This was a prospective pilot study of 29 adolescents recruited from a pediatric Emergency Department (69% female, mean age = 14.0 years, SD = 1.8) following a concussion. Methods: Adolescents completed questionnaire assessments at baseline, Weeks 1, 2, and 3 on PCS and sleep patterns. Concurrently, adolescents also completed a daily diary and wore an actigraph continuous...
Source: Brain Injury - Category: Neurology Tags: Brain Inj Source Type: research
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