Pass the PSA, 1e

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Each question carries 10 marks, where 5 marks are for the drug choice and 5 marks are for the dose, route & frequency. A perfect answer scores 5 marks, a suboptimal answer scores between 1 to 4 marks, while a wrong answer scores 0 mark. Note that the mark you get for dose, route & frequency cannot be higher than the mark you get for drug choice. After finishing the practice questions, find out if your answer for each question is correct. You should understand the reasoning behind every correct or wrong answer. Meanwhile, if the there are clinical features of toxicity, stop the drug temporarily and treat the toxicity, then either restart it at a lower dose or switch to another drug. If the plasma concentration is above normal but there are no features of toxicity, then decrease the dose. The required percentage of reduction in the dose is usually the same as the percentage of reduction in the plasma concentration that you want to achieve. Delivered jointly by the British Pharmacological Society and the MSC Assessment, the PSA is an online exam designed to assess your knowledge, skills and judgement of prescribing medicines within the context of the NHS. This includes writing, reviewing and amending prescriptions, calculating drug doses, and identifying adverse drug reactions and medication errors. You will be given a clinical scenario and a list of 6-10 drugs the patient is taking, you will need to identify drugs that are contra-indicated (e.g. in renal impairment), causing the clinical picture (e.g. hypokalaemia, confusion, hypotension), or contain a dosing error.

The Prescribing Safety Assessment (PSA) is a pass/fail assessment of the skills, judgment and supporting knowledge related to prescribing medicines in the NHS. The PSA assesses the prescribing skills of final-year medical students and is based on the competencies identified by the General Medical Council outlined in Outcomes for graduates (originally published in Tomorrow's Doctors). These competencies include writing new prescriptions, reviewing existing prescriptions, calculating drug doses, identifying and avoiding both adverse drug reactions and medication errors and amending prescribing to suit individual patient circumstances. The content of each item is relevant to the prescribing tasks expected of an F1 doctor, i.e. the questions refer to ailments and drugs that graduates are likely to be dealing with in year one of the Foundation Programme. Sp aced repetition is a technique for improving the retention of information . It works by spacing out the intervals between review sessions . This spacing allows you to consolidate the information making it more likely you will recall it during the prescribing safety assessment. Prescribing is a fundamental part of the Foundation Programme as doctors will write and review many prescriptions on a daily basis. The British Pharmacological Society and MSC Assessment have worked together to develop the PSA which allows all final year students and postgraduate doctors to demonstrate their competences in relation to the safe and effective use of medicines.Based on the information provided, you have to decide whether to stop a drug, decrease the dose, increase the dose, prescribe another drug or make no changes. Don’t lose easy marks! As prescribing counts for a whopping great 40% of the marks don’t lose out on the ample marks available for your signature and the date! If the assessment is formative, candidates who do not pass the PSA will be given two further opportunities during FY1 to pass the assessment to be awarded the Foundation Year 1 Certificate of Completion (F1CC). Non-UK medical students applying to the foundation programme will be expected to take the PSA within their foundation school doing their FY1. Get ahead! The Prescribing Safety Assessment’ by Muneeb Choudhry, Nicholas Rubek Fuggle and Amar Iqbal

You should also revise the fluid management, opioid pain management, insulin management and pre-operative management topics in the Oxford Handbook of Clinical Medicine. Questions on these topics are common in the PSA and many find them difficult. Fluid management is particularly important. The PSA is an essential component of demonstrating the necessary competences for successful completion of the Foundation Year 1. It is a national requirement for all F1 doctors to demonstrate a pass by the end of the year. All foundation doctors will be required to pass the PSA before being signed off as having successfully completed the F1 year and being awarded the F1CC. If the PSA was passed more than two years before starting foundation training, it will need to be successfully retaken before completion of the F1 year. I found the actual exam harder than I expected, though manageable. I fortunately had time to spare at the end of the exam to review some of my answers, though I know many of my peers ran out of time and year on year this is a common complaint. There were many questions which I wouldn’t have answered correctly had I not known how to navigate Medicines Complete, so I do think a keen awareness of this resource is pivotal for passing the PSA. For the fourth type of question, you have to determine the immediate next step of management that is most appropriate for the adverse drug reaction. It may be pharmacological or non-pharmacological management.The BNF may be able to help, but only in some cases.

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There may be more than one correct management options, but one will be better than the others. Ensure that there are no contraindications to a particular management option before selecting it. You can look up the BNF for the contraindications of each drug. Read carefully whether you are being asked to assess that the treatment is working/ beneficial or whether you are assessing for adverse effects – you will do different tests for each of these. Calculationsarounddrugconversions-againlookatthePASSthePSAbookonesandknowtheconversionof1%2%intosuitablecalculations.Somewillbebasicratios As well as a detailed explanation for each PSA question, our question bank platform will display a relevant topic snippet (if available). For example, if a question asks about asthma management, a topic snippet covering asthma management will be displayed. Advanced analytics