FACTM exam briefing

ACTM Large 150


When
:

Friday, 3rd December, 2010.

  • Paper 1 at 09:45-12:15pm
  • Paper 2 at 13:45-16:15hrs
  • including 15” instruction & reading time, 2hr writing time and 15” administration window

Where:

In Townsville and Perth, plus any other major Australian centre, in accordance with demand and availability of exam supervisors/venue.

Who:

  • A   FACTM (Clinical) Medical graduates qualified and registered to practice in Australia or New Zealand. Overseas qualified medical practitioners currently licensed to practice in either Australia or New Zealand (e.g. as trainees or on conditional registration) will be eligible to enter for the FACTM examination. At least two years of medical practice and some experience in tropical or travel medicine are advisable. Those with less clinical experience will be expected to make a case for early entry in order to avoid disappointment.
  • B   FACTM (Paraclinical). The Paraclinical Fellowship exam is designed for other health care professionals qualified and licensed to practice in Australia or New Zealand with an interest in tropical or travel health e.g. paramedics, remote area nurses, travel health clinic staff, medical laboratory scientists, epidemiologists, veterinary medical and scientific officers, pharmacists and other professions allied to medicine

How:

  1. Register your expression of interest with the College Secretariat and apply for the Affiliate category of membership (the application form can be found on the ACTM website) before 30th September, 2010. If you have recently completed a Diploma in Tropical Medicine recognised by the College, you may apply for recognition in lieu and exemption from the part 1 exam (Clinical).
  2. Indicate your preferred exam centre, your 2 referees and the names of any senior ACTM members who are willing to act as local exam supervisors.
  3. The College will contact you with detailed exam instructions including an invoice for exam fees ($500)
  4. Complete your exam revision
  5. Attend examination centre and complete papers 1 and 2
  6. Results will be communicated to candidates via the College Secretariat after completion of marking, audit by the external examiner and review by the College Examination Board.
  7. Candidates must achieve an overall mark of 50% in both papers to be granted a pass and MUST achieve an aggregate score of at least 60% in their preferred topic. For FACTM (Clinical) candidates, the preferred topic is automatically Clinical Tropical Medicine.
  8. No grades other than PASS or FAIL will be given, however the highest scoring successful candidates in each of the Clinical and Paraclinical streams will be recognised with a College award.

What:

  • Paper 1 will comprise different multiple choice question formats, including 30 x 5 subquestion T/F from a bank of 45 arranged by topic area (i.e. 150 x T/F) with negative marking, and 20 x 5 objective structured questions from a bank of 25 without negative marking. Total marks will be expressed as a final mark out of 50 plus a subtotal for the preferred topic.
  • Paper 2 will comprise 10 data interpretation questions arranged by topic of which 8 must be attempted, and 10 short notes questions of which 8 must be attempted. Short notes questions will be designed to be answered succinctly in table, dot point, annotated list, graph or sketch diagram form. Total marks will be expressed as a final mark out of 50 plus a subtotal for the preferred topic.

Recommended revision plan:

  • A    Clinical: use the Oxford Handbook of Tropical Medicine as a baseline, supplemented by the respective chapters in 22nd edition of Manson’s Tropical Diseases, and the core text books for your chosen three other topics. Aim for a DTM&H standard of knowledge and use the sample questions with worked answers on the College website to assess your knowledge. Supplementary revision material can also be found on the MicroGnome website. When using other study materials, seek an Australasian perspective on the subject matter.
  • B      Paraclinical: use the core textbooks in the recommended list to master each of the four topics. Priority should be given to health issues of direct relevance to the Australasian region, as applied by health practitioners in Australia and New Zealand. Ensure a good grasp of the common, the serious and life threatening. The part 1 exam will emphasise breadth of knowledge with practical use in our region. Sample questions with worked answers can be found on the College website. These examples are not exhaustive, nor are revision materials.

If in doubt about the scope of knowledge required, use the recommended textbook for that topic as a guide.

TJJI for the IEB, 13-AUG-10

The end of the earth

Barra airport

To the Ends of the Earth is the theme of a day conference on wilderness and expedition medicine we’re running with the Rural Clinical School in Bunbury this coming October. Further details on the enclosed poster, which you may want to download, print off and circulate to anyone interested in medicine, paramedical work or first aid in wild places.

The Romans called the very edge of the known world ‘ultima thule’; a place that probably equates to the Outer Hebrides.

The MicroGnome has been to this particular candidate for the World’s End and found a wild but very beautiful landscape of islands set among fingers of the Eastern Atlantic.

Barra is at the far end of the chain of inhabited outer islands and can be reached by ferry from Oban on the mainland or from  Lochmaddy to the north.

The quicker alternative is to take a British Airways flight and land on the beach – time subject to tides. Here’s what’s in store if you want to get to the end of the earth in a hurry.

Leishmaniacs

Calling all Leishmaniacs:  it’s time to move on from tropical infections of the gastrointestinal tract to one of the most interesting of parasitic infections; Leishmaniasis. Next Tuesday’s Tropical Medicine Breakfast will cover the subject in two units: clinical tropical medicine, and clinical parasitology/entomology. The emphasis will be on Leishmaniasis as seen in Australia.

Download (DOC, 173.5KB)

For those working towards the ACTM Fellowship exam there are some useful on-line learning resources:

Solar powered RMO?

It’s near the end of a winter week on call and I’m getting ready to jet off to plan another bug-hunting adventure. No boxes, lab gear or cold reagents to worry about this time. Just ideas and a B5 notebook. Some things need sketching out in pencil on a clean sheet of paper before they can fly. So the MicroGnome will be absent from his desk for a couple of days; disconnected briefly from a reliable Blogging engine. But do not fear; the next Topical Medicine Breakfast has already been prepared, supplementary material for the last TMB is under starter’s orders, and there will be an on-line version of this week’s talk on field applications of molecular microbiology up on this site very shortly.

In the meantime, you need to take a look at this futuristic introduction to social medicine from our supporters at Life in the Fast Lane. Here you will encounter such exotic species as the solar-powered RMO (yes, the light’s just gone on and, no, the sun does not necessarily shine out of his mouth or any other orifice). Clearly the jungle is full of wonderful beasts. After the MicroGnome’s initial, jaw-dropping awe had subsided, he began to consider the possible consequences for zoonotic infection when mere mortals stray into the social medicine jungle. LITFL’s guide hints at navigation aids for the beginner. Could there be a field guide for the novice backhacker?

Abdominal pain in an overseas resident

CT upper abdomen showing hepatic lesion

Clinical case of upper abdominal pain in overseas resident

A 54 year old businessman presents with right upper quadrant pain after spending the last six months living in Java.

An ultrasound scan revealed gallstones. A laparoscopic cholecystectomy was then performed. At this point a lesion was observed on the surface of the liver, but not biopsied.

Four months later, on another return visit to Australia, the patient re-presented with fever, a cough and pain radiating to his shoulder tip. He was admitted to a district hospital and a chest X-ray performed. Changes consistent with right lower lobe consolidation were observed and intravenous antibiotics (i.v. Ticarcillin/Clavulanic acid) commenced. The patient did not improve and was transferred to a larger hospital.

After 7 days of intravenous antibiotics he coughed up a large quantity of viscous, brown phlegm with a paste-like consistency. These CT scan views were obtained at this point:

CT thorax after coughing up 'anchovy paste'

 

CT upper abdomen showing hepatic lesion

 

The patient’s serum was sent to the Microbiology laboratory with the following result:

Entamoeba histolytica titre > 1:4096

This was seen under the microscope in the paste-like sample of phlegm:

Microscope view of patient's sputum, showing microbe with internalised red cells

 

Q1   What do the CT scans show?

  • CT thorax: peri-mediastinal opacity
  • CT upper abdomen: smooth-walled lesion within liver

Q2   What object was seen under the microscope?

  • amoebic trophozoite  (Entamoeba histolytica) containing erythrocytes

Q3   What pathological process explains these observations?

  • amoebic liver abscess with trans-diaphragmatic extension and rupture into a bronchiole or bronchus, probably during coughing

Q4   What treatment would you recommend?

  • 750 mg Metronidazole i.v. x3 doses x 10 days
  • followed by paromomycin x3 doses