I’ve been inspired by a colleague to write one last clinical reasoning blog before the KFP tomorrow.   Don’t worry, it’s not going to be one of the usual deep and meaningful ones, just something to ponder whilst you’re trying to fill in your time until tomorrow.

Let’s try a visualisation.


You are tired of studying.   Your brain has had enough fun.  You decide to take an afternoon walk to clear the cobwebs and be ready for the morning.   There is an awesome sunset but a few dark clouds on the horizon.  Do I take my umbrella?  Why not?  Better to be safe than sorry.   You start walking, just a slow amble to try and burn off some of the nervous energy and ensure that you have a good night’s sleep.  There’s a lovely breeze and you can hear a cacophony of wildlife in the trees.

It starts to spit rain – just enough to be cooling but not annoying enough to turn back for home.   It’s not time to open the umbrella yet as you know there is a covered picnic table a few hundred metres away where you can shelter.  You’re thinking about the morning – what to wear, what to have for brekkie, where you’ll park, how you’ll feel whilst waiting for the exam to start – and how good it will feel when it ends.  You have prepared well and are anticipating the challenge of showing off your knowledge.

It’s spitting harder.  Actually, not a spit, more like a trickle.  The clouds are looking like ominous black sponges about to wring themselves out on top of you. 

In the midst of your daydreaming, you’ve wandered a little farther than you anticipated and into a new part of the park that you haven’t been to before.  Should you find some shelter?  But where? This is unfamiliar turf.   There are some trees in the distance but what if that sheet lightening you can see on the horizon becomes a bit more pointed?  Lucky for a contingency – lucky you’ve brought your brolly.   You pop it up and are grateful for the shelter but it’s a little late.  By the time you make it home you are calmer, tired, and utterly drenched.   You’re kicking yourself – if you’d put up the brolly earlier you might not have lost your way and gotten so wet!


Tomorrow is a big day and you’ll need an umbrella.   Pragmatically, you don’t want to get wet on the way to the exam.   Sitting in wet clothes for four hours is no fun.  Tomorrow is about contingencies – thinking ahead, exploring all the options, and making a plan, so you don’t get stuck unexpectedly in the rain.  Clinical reasoning requires knowledge – all that stuff you have jammed into your head over the last six months.   If you choose to reason from a narrow set of options, your answers will be limited and you’ll get wet.

If you put up your brolly early and think broadly, you will be protected from the elements by an umbrella of differentials – you will buy yourself time to make good decisions about how you can best stay dry!

Please feel free to comment.

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