Assessment Domains

Typically, there will be between three and five domains assessed in each station. The candidate performance on each separate domain is rated on a seven-point scale. There is no pass/fail point for these ratings.

The expectations of the candidate are described specifically for each domain as relevant to the individual station. The below are generic descriptors of what may be included in each domain.

For more information on the marking system of the clinical examination, please visit the Clinical Examination Specifications.

Approach to the patient, their relative, a carer or another health professional

This domain refers to the way you interact with the patient or their family, and your ability to demonstrate:

• Empathy
• Respect for patient autonomy
• Cultural sensitivity
• Flexible responsive communication style
• Avoidance of technical language
• Checking of patient understanding
• Managing expectations

History

This domain assesses your ability to:

• Identify key symptoms
• Identify relevant clinical and contextual information
• Identify relevant positive and negative findings
• Integrate initial history to inform subsequent inquiry

Choice and technique of examination, organisation and sequence

This domain assesses your ability to demonstrate an examination with:

• Consideration of patient comfort, safety and modesty
• Relevance of examination components to patient’s presenting complaints and medical history
• Logical and efficient sequencing of actions
• Inclusion of all required elements
• Matching level of specificity of examination to clinical context

Accuracy of examination

This domain assesses your ability to demonstrate:

• Thoroughness and precision of technique
• Identification of relevant signs and symptoms including severity
• Accurate reporting/ documentation of findings
• Integration of initial examination findings to inform subsequent examination elements

Familiarity with test equipment

This domain assesses:

• Familiarity with and proficiency in using medical equipment and devices relevant to the specialty
• Demonstration of correct handling, operation, and maintenance of equipment

Performance of procedure

This domain assesses:

• Consideration of patient comfort, safety and modesty
• Explanation to the patient
• Precision of technique
• Procedural accuracy

Explanation of procedure

This domain assesses:

• Explanation of the purpose, steps, and potential risks of a procedure in a clear and understandable manner

Commentary to examiner

This domain assesses your ability to:

• Provide clear, concise, and comprehensive descriptions of clinical findings
• Correctly interpret data
• Justify diagnostic and management decisions

Choice of investigations

This domain assesses your ability to:

• Integrate clinical indications, context, patient history, and examination findings in investigation selection
• Demonstrate knowledge of investigation indications, limitations, and interpretation of results
• Include all relevant investigations including unlikely but important diagnoses
• Avoid irrelevant investigations

Interpretation of investigation

This domain assesses your ability to:

• Correctly interpret data
• Describe normal and abnormal results and implications for diagnosis and management
• Logically integrate test results into clinical decision-making

Diagnosis/ differential diagnoses

This domain assesses your ability to formulate a diagnosis/ differential diagnoses that includes:

• Integration of history, examination findings, and relevant investigations as appropriate
• Consideration of likely conditions that could explain the patient’s symptoms
• A sufficiently complete list that includes unlikely but important diagnoses
• A description of clinical reasoning

Management plan

This domain assesses your ability to:

• Demonstrate evidence-informed approach
• Include treatment options, follow-up considerations, and addressing potential complications
• Tailor management to match the urgency or severity of the situation
• Respond to patient preferences where these are expressed

Patient counselling/education

This domain assesses your ability to:

• Effectively communicate with and educate patients regarding their diagnosis, management options and prognosis
• Address concerns, answer questions and obtain consent
• Discuss risks and benefits of any proposed management plan