[Music] I passed my IP exam um quite recently uh November 2021 if I can remember um it seems quite long ago so I thought it would be useful um after I sat my exam I thought it was very different to any exam that I'd ever sat at Uni now I don't know if there's some young upts on here that have maybe done online exams or not but for me it was a completely different experience and I kind of wish I had a bit of hindsight looking back and how it was going to run so what I've done is I've made a quick presentation just with what to expect in the exam just little tips here and there and then yeah I've got five patient scenarios that we're going to go through um we're not going to treat it like a mock exam we're just going to discuss it because I think that's the best way because if your exam's next week you know you're already know what you're doing um this is just like kind of a final refresher basically um so let me just try and share my screen and also my dog is around so Herby might come and say hello at some point but we'll see right so let's go for exam prep can you guys someone just tell me if you can see my screen okay someone show say hello yes oh thanks Angie right ok doie so you should already have some information about the exam format so the college tends to send this out in advance um the exam is over this test reach platform so you should hopefully have already downloaded that and run through a little tutorial because that has to be set up before your exam so the format is you've got 85 questions to work through 75 of them are real and 10 of them are pilot questions so the pilots you're not going to be assessed on the exam funny timing it's 102 minutes so roughly go over a minute for each question if you like to think about it that way and the questions are going to be made up into patient scenarios so in the next part when we go over patient questions I've try to make it look as similar to what you're going to find in the real exam as possible um there's a couple of questions that they're not McQ format just for kind of discussion sense but we just yeah you'll see what I mean we go into that and yep the exam is pass or fail the pass Mark changes year on year um but you don't you know you don't have to worry about that as long as you pass that's the main thing so here's the pass rate for the past few years so there was me down November 2021 you can see quite a high pass rate now what you'll notice is as we go kind of closer to the Future the P rate seems to slip down now don't know why that would be um my theory is up here in the higher pass rate marks that was when we were still kind of midco um more people maybe had time to study maybe not working as much I don't know but don't be discouraged by this don't be discouraged that the P rates Dro down just focus on your exam and try not to think about what's happened before okay so content is going to be based on just the cmgs so the biggest thing to know is that you're not going to answer with what you would normally do in practice this is the biggest challenge when you're setting this exam it's fighting those instincts it's finding what you would normally do and purely answering from what the the cmgs tell you to do um you used to have a higher percentage of questions based on glucoma but that's now reduced to about 10 % for those questions you're going to follow sign or nice and yeah like Louise said we've got a couple of candidates here from England and obviously Scotland England Etc we've got slightly different guidance but there will be no questions that are contradictory between the two so the exam is Sat by a standard setting panel and if they come across any questions that are like that then that question will get scrapped so don't worry about oh Scotland would answer this way England would answer this way you're not going to find that so when you're thinking about where to set your exam you have to think quite carefully initially I thought I was going to set it and work but I'm actually glad that I sat it at home because there's always a risk that if you're doing it in work someone's going to knock your door you know you might get an emergency that pops in so yeah try and find somewhere that is free from distractions you do need to be aware that you're in is going to ask to see all of your surroundings so they're they're going to ask you to try and move your webcam so I've got my laptop set up they got me to LIF my laptop and do a total 360 of the room they're basically making sure that you've not got notes or anything stuck behind the camera or anything like that um what was quite weird was that the lady asked me to go and find a mirror so that I could show her the front of my screen as well so I had to get the mirror off the back of my door and hold it up which was strange and that did that rattled me before the exam because I wasn't expecting to have to do anything like that so yeah just be really aware of your surroundings make sure everything's tidy all good um you are allowed to BNF but you're only allowed a paper copy so you can't use it on a Kindle iPad anything like that you can put sticky notes so what I did before my exam was I put a sticky note and thought what would be the most relevant section so UTIs herp Simplex glucoma those kind of bits that I could quickly refer to but they will ask you to show your BNF to make sure that you've not written any notes on the inside you are allowed a bit of paper for notes though so you're allowed one A4 sheet that you can scribble some notes as you do the exam but again at the end they're going to ask to see that so they'll want front and back um and also you need to have photographic ID so passport driver's license whatever you've got so yeah like I was saying the online invigilation it can be quite intimidating um throughout the exam they are constantly watching you but you cannot see them so that's a bit disconcerting you have to make sure that you're always within your little window even something simple like you know you reach out of you to grab a bottle of water you get a warning if you go out of view um because they don't know if you're going out of the camera view to look at notes could be Bend under your desk so if you do that too many times they will speak to you and they will give you a warning I cannot remember how many warnings you get before it's marked down as a serious incident um I think the test reach program will tell you what to do I don't think anyone would ever get to the point where the invigilator is going to stop the exam but it's just it's common sense just try and stay the window as much as you can um the other thing they'll ask you to do so we'll get get you to roll up your sleeves and if you've got any smart watches fitness trackers they're going to ask you to remove that so there will be a timer on your screen but the only kind of watch you would be allowed would be an analog one and they're going to ask as well for you to show behind your ears so if you wear a kind of a head covering if you've got your hair over your ears they're going to ask you to move that just so they can see so yeah those kind of things made me feel quite nervous even before the exam started but it's actually fine so we bit on timing like I touched on at the start just pay attention to the onc screen timer I can't remember if it runs down or if it runs up but you'll see when you actually do it but don't panic because you've got plenty of time um myself and my friends that sat the exam at the same time we all finished really early and we worried that we'd rattle through it and made mistakes but yeah you'll have plenty of time um some questions you'll be able to answer really quickly because it'll just be Quick Knowledge Questions you'll end up banking that time so the questions that you do need a bit of time to think about you're going to have enough time to think about so yeah just this is all and you'll have done this your whole life set an exams exam technique just pay attention to the number of answers that some of the questions asked for so it might be pick the top three out of these seven options or it might be pick the most likely and there's multiple choice just simple things like that just make sure that you're reading the question because you can't go back that is one thing about this exam once you move on to the next question you cannot backtrack that can be quite worrying when you realize that you've made a mistake but the only thing I can say is just try and reset your mind realize that you've made a mistake but move on there's no negative marking so if you realize that you've made a mistake which we'll talk about when we're doing the kind of example questions just go okay I now have this bit of information that I got wrong let's answer the question as if I got that right so yeah that's it's a difficult thing knowing that you can go back but just try and focus on the question at hand and you should be okay and yeah if a question seems strange if you're reading a question question and you think this doesn't make sense I've never seen this come up in the CMG it's probably a pilot so if there's a question that you're really worried about just think that it might not get marked in the end okay and then yep once you've sat the exam your results are going to come out about two weeks after and yeah I've already said the pass Mark is going to be a bit different they're going to grade it on how ad just compet optometrist would do so they're not looking for you to be an IP genius at this point they're just looking for you to be safe and to be safe you need to know the cmgs so at this point you are going to be there you just have to be confident and know that you can do it so yeah good luck we'll have a look at some questions now um before I go on to the questions stop sharing yeah before I go into the patient questions does anyone have any questions about the exam and how it runs or indid or anything so far no questions or anything you can unmute or you can type in the chat box if you'd rather have a sip of tea while you m that over there's nothing coming into the chat box so unless anybody's got anything they want to unmute and ask personally we can move on yeah I think yeah it's pretty straightforward I think you guys are quite good you're very switched on sorry sorry can I just very quick very quick question it's it's what you said about the Scottish English nice things obviously the the standard is slightly different for Goldman with the different referrals it's like by one you know are was just a bit do we need to know both very well I don't know no so just know what you would do so when I say that none of the questions are going to be ambiguous the pressures are going to be Skyhigh so oh I see It'll be so say for ex say it was like primary open angle they'll say oh patients pressures were 29 and 31 it's going to be it's not going to be those borderline questions okay if you do get a question that you think well this is borderline like the CCT and the pressures you know this could be this it could be that it's probably going to be a pilot but yeah they tend to be really obvious with their pressures yeah that's great thank you that's okay um and any other questions from anyone NOP um you can like if you think of a question later just pop it in the chat box and we can get it to the end but if you're happy we shall have we look see at some example questions so I'm going to be second share my screen so not technologically tuned in right okay and again if someone can just give me a shout if you can see that okay that's great y thank you okay so yeah like I said we're not going to treat this as a mock exam we're just going to treat it as here's some example questions and we can talk through them hello Herby so these are what I've basically made these questions up um I found this quite useful when I was studying just to kind of make up false questions and try and think how they're going to be worded and what they might be looking for so all of these are fake um so as a result some might have more than one correct answer but if we do come across any we can discuss that and like Louise said we're really lucky that we've got Sanji here so Sanji as our clinical expert can answer any tricky questions if we've got any right so patient one you've got a 33y old male presenting with a red painful watery right eye he's reported a drop in Vision in the affected eye and it's very light sensitive he's in good General Health but noted feeling a bit rundown he did mention that he saw the Eye Hospital for something similar when he was in his 20s so a slit lamp is showing some multiple opak cells and a state pattern um I've just realized I've put left and right eye right okay it's all the same eye just ignore that that's me being daed so stellate pattern cornal epithelium progressing to a linear branching ulcer dilated fundus exam is normal so what do we think the likely diagnosis is now hopefully at this point you guys are going to know you know that's quite an obvious one so we'll skip forward you diagnose hair simplex keratitis so if I just scroll back this is what your exam is going to look like so you're going to have a patient case as we call it so you've got that bit of information up the top and then you've got questions down the bottom what happens is when you move on so you go to the next question all this information at the top is going to move on to the next page so you do not have to memorize all of this so all of that in a we story is going to keep getting added on so you're going to have that information and then you're going to have you diagnose herpy simplex keratitis so say for example you got that wrong say for example you've put bacterial conjunctivitis and then you go to the next question and you go oh my goodness it was actually herp Simplex fine just treat it as herpes simplex because that's what you know know it is so speaking of what are we going to use to manage this condition so you're going to think oh this is the other thing sometimes it will give you the kind of name of the drug sometimes it'll give you the brand name so you do have to know which is which that's what your BNF is for so if you don't know what XIs in or vergan is then yeah just look it up in your BNF so anyone want to Hazard a guess um unmute yourself think what we're going to give this patient C see yep perfect so you're going to give the vergan Opthalmic gel and correct so you've chosen to prescribe next part is you review the patient in two days time but the patient is reporting worsening symptoms you're now seeing stromal infiltrates what is your management now so are you going to continue treatment is it going to be a routine referral is it going to be a same day referral to the GP urgent referal to the hospital or same day referal to the hospital um and generally when they say urgent they are specifying within the week so we'll move on just so you can see and you're referring same day to the hospital so just before we move on to the next patient case does anyone have any questions about that I thought that one was fairly straightforward no no questions can I have a show off hands um so what do you think the hospital will do anyone volunteer rosie come on I'm GNA pill you pick you I'm just going to put it out here that I'm not actually at the stage where I'm said in my college exam just yet so I'm I'm only in the Master's part from GCU um I don't know are they going to give are they going to give something more potent that we can't give or are they going to give something systemic genuinely no idea systemic so so the point is is the EP yeah epithelial is now gone to stromal which is an immune reaction to um the the the virus rather than just the epithelial reaction so most likely if the epithelium is healed and the stromal keratitis then it's an immune reaction so you give asy 400 BD but possibly with steroid for the um secondary inflammation so just just um to complete that just in case you got that EX in in the exam and that's actually a good point so some of the questions will ask what is going to happen at the hospital so that is also in the cmgs so right at the end of the cmgs you've got possible management by opthalmologists so yeah even though you might think to yourself well I don't need to know this because I'm going to send it to the hospital you will need to know for the exam what's going to happen so yeah just make sure that you're revising that too sorry to pick on you Rosie did well though that's all right I'll cope okay so patient two this time we've got a 25y old woman presenting for an emergency appointment with a very painful red left eye that is sensitive to Bright Light you do your assessment and you know circum cornal injection fine KS anterior chamber cells and flare and a constricted non-reactive pupil in the left eye the right eye is unremarkable so this question it's telling you straight away what you're diagnosing so sometimes you'll find that too so it's telling you anterior UTIs in the left eye now it's asking you which two assessments are essential to do for this patient so I think this is one of these tricky questions that you have to look through them all and really think to yourself right out of these what is going to help me to differentially diagnose um the best so sorry if you can hear my dog barking in the background um so what do we think here so what two do you think you would choose out of 1 two 3 four five six seven eight again if anyone wants to unmute and shout out I mean there's already There's A and D B and D yeah perfect yeah that's absolutely spot on um so I I thought this was quite a hard question so yeah amazing um if you didn't know being D straight away guys you can already rule out quite a lot of these you can just score out like cover tests I mean what's that going to give you you're going to score out chemetry OC you know because it's the front of the ISU so yeah well done you guys that got pressures and dilated fundus exam so which two drugs are you going to use to manage this patient now like I said there's no ambiguous questions they're never going to give you incorrect percentages of drugs so they're never going to make up cyclop penate 5% or flu methylone 3% so you don't have to memorize things like that but you do need to know which one you're going to use to treat a certain condition so again thinking logically here you can rule out three because you're not going to give tropicamide so that leaves you with A and C um one of these steroids is going to work better than the other for anterior UTIs and hopefully you know by this point which one you're going to pick so you're going to go for C there we go so you're prescribing your CYO and your thread you review the patient after 4 to8 hours and thankfully it's responding well to treatment so you're going to reduce the steroid and then begin tapering so I've got a Bonus question so the patient mentions that this happened to her last year and she received the same treatment this isn't a multiple choice question but what would you do now you know she's had it before what is your next step after you start treatment again if anyone wants to shout out doing the chest buzzle go says routine referral to hospitalized service and this um refer for systemic testing so a couple of chat box oh it's on the chat box sh so yeah perfect so you're going to refer for systemic review and possible onward referal to rology um so in the real world um I've got a couple of patients that have had recurrent UTIs and I have referred them for systemic review and for whatever reason it's not been done um so again you know things that happen in the real world might not match up what the cmgs say you just have to know what's in the cmgs um so again another bonus question which of the following conditions are associated with antiuv itis so pretty much all of them I think you know as well okay so just just a point there CLA um yeah all of them and uh they're linked to um h27 and that comes under um all hlab27 positive which almost comes with sometimes bilateral or sometimes like uh you've got sarcosis where you almost get like a mutton fat KP um but yeah all of them come under the same called hb27 positive disease what oh you want that okay I'm listening about v27 I had somebody's getting show to that in the background yeah stop talking to me if it's not important I'm doing C right um so next question so the patient identical twin sister right whoever shouting background if you can just mute yourself for a second we're just getting a bit of cross over here thank you okay so the patient's identical twin sister comes in the following week with the same condition okay uiis but this one she's complaining of a significant reduction in vision and unbearable pain you check the pressures and you find them to be significantly raised and the twin is hoping for the same treatment as her sister but what is your management going to be so would you yeah start on the same treatment um would you start on the treatment and refer would you add in a hypertensive drug because the pressures are raised or would you refer it onwards so this is like a little tiny section in the cmgs which is why I thought I'd put it in because it's quite important this one you're going to refer CD so whenever you've got UTIs with a significant reduction in Vision significant pain and raise pressures yes yeah you're going to want to refer that same date pleaseed to say there are few people in chat box who have answered D which is great yeah I think to be honest with your exam being next week your guys are already going to have all this knowledge this is just going to be like a final refresher so that's good okay so patient three um Mom brings in her eight-year-old son sudden onset pain and swelling in the corner of his left eye red tender swelling over the lacer extending around the orbit we boys flinching away when you try to assess in more detail as kids tend to and the mum notes that when you touch the lump it's expressing a purulent discharge from the punct eyes are otherwise unremarkable motility is fine and there's no tosis so you diagnose acute daos cystitis what is your differential diagnosis so again I'm just going to show you the answer because this is not an MC format it's just to get you thinking about it so yep you can rule out all of these given the history which is Grand what is your management so you've got an eight-year-old boy so you're going to have to think about the age here for your management yeah same D referal nice and easy so yeah when you look at the CNG for the acute daos sotis with kids you just basically don't want to touch it you want to send on to the hospital with that in mind if it wasn't the son if it was the mom that came in with the same condition what would your management be so I'll let you have we look at the options here again this is one of those tricky looking ones you just have to sit and logically work through so are you going to prescribe or are you just going to refer for the mom bearing in mind that we refer the kids you're probably thinking that we're are going to prescribe for the mom anyone to Hazard we guess with what we're going to use there's three answers in the chat box all of them are a of four perfect excellent so yeah there's a couple of daff things like why would you give a seat is all about I mean you could but it wouldn't be a good option so yeah there we go okay so any questions about patient scenario 3 before we move on nope I think we're all good okay so patient 4 55y old blueeyed female just think about why I've specified the eye color here with Hyper metropia present an emergency complaining of sudden onset blur Vision severe ocular pain and redness in the right eye she reported having similar symptoms along with Halos around lights last week but only last lasted an hour or two and she thought it was just a migraine but this is much worse you do an assessment you find dilated limble and conjunc vessels a fixed semi- dilated pupil Cornel EMA van herck grade one pressures were 34 and the right eye and 21 in the left so yeah pretty obvious here what do you think your diagnosis is going to be and hopefully all of I've just realized I've put OMG that's wow that's that's clearly me trying to be funny never mind that but yeah so you know it's angle closure okay so you diagnose it and you decide to refer same day to the hospital which yes you would do now what drugs can you give before sending the patient to the hospital I specified her eye color so she's blueeyed this plays into one of these pillow carpon things here so anyone want to think what we're going to give here for this patient again it's quite a tricky one so we so we think her I'll just move on I'll move on just so you can see um so you want to give them oh what were you saying I think someone tried to say something there nope um right okay I'll just move on so you're going to give them Hal carpon 2% because they are blue-eyed if they've got brown eyes it's the 4% and you're going to give a single dose of 500 acetazolamide and then you're sending the patient to the hospital accompanied by their partner which is quite important if they've got someone with them and this is quite a common question um I had a couple of these in my exam what are General side effects of a certain medication so in this case you've got your acetazolamide these are the ones that will take up a lot of your time if you don't know if you don't memorize a lot of the side effects which to be honest I didn't for every drug you're going to have to look up the BNF and you're going to have to work your way through so I'll just give a couple of minutes actually so you guys can look over this um each of these are attributed to a different medication which you know forun you can maybe tell me what you think each them are attributed to but yeah when you're ready if someone wants to try and Hazard a guess with what the answer is here because there's a couple yeah there's a couple of these side effects that are classic to AAS all mod couple of Cs coming through which is good um I think um while we're waiting for everybody to think over so there was a question in the chat box saying why 250 uh why why 500 milligram not not 250 and that's actually reason being if the pressure is high 250 probably is not good enough I would say it will reduce but you you want if it's angle closer you sometimes have to give 500 give it at least an hour and probably repat it if they if they've had anything to eat so you want to almost give the maximum dose that is available um so 500 milligram will be definite I also wanted to mention something here that while spoar pin 2% is a good idea in blue eyes but if the pressure goes over 40 mm of mercury and still patient is an angle closer the pilocarpin doesn't work because pilocarpin works if the vasculature of the um and it gets such a shock that the pilocarpin will not work so you have to give them diox repeatedly um if they're not asmatic um then give them coopt uh latanoprost to bring the pressure down and when it's less than 30 then the pyocin will start working so just a little Point not that you might get that in exam but just just as a practical tip um couple of people had um guessed U or or had given the right answer of B here yeah so that's good um so yeah trick here I think in in my opinion there's a few overlaps but tingling is probably quite important and tingling is a very very common side effect of um acetazolamide and also as well I think a metallic taste is what a lot of people complain about y oh yeah that's good that's really good guys if you've managed to get that one cuz that one can be a bit tricky so e um somebody guessed about e and I think that's more toward tetracycline or yes discoloration of teeth and photosensitivity but you might get a question that as about the side effects of tetracyclin so you'll need to know about that as well yeah cool okay moving on patient five this is our last kind of example patient so 58-year-old man presents with bilateral ocular discomfort Lids are quite hyperic and thickened with tanasia of the lid margins you've got some tear FAL instability and you're noting some corneal punct te staining you also find that his face is rather flushed and he's mentioned that he's been diagnosed with rosacea by his GP this is quite important as pair the cmgs that he has a formal diagnosis of rosacea by his GP so first of all you just want to think about what nonpharmacological advice you can give because some of the questions will ask that they'll ask well you know you're not prescribing what can you do so for this patient we're thinking about ocularia try and avoid the cause of exacerbations think about Omega-3 supplements manage anything that's associated with it and also you've got the option of IPL therapy and then of course what pharmacological managements are there so you've got lubricants which is always going to be your first line treatment and then you've got your oral antibiotics so that again is something to be careful of with the questions they will ask what is your first line treatment so some of your options might be um so you got Hy pero sodium hyaluronic doxic cycl blah blah blah if it asks you for what your first Lane treatment is all always think it's the first thing in the CG so the basic your lubricants is what you're going to give first okay so Y part of the the oral antibiotic that you would prescribe doxic cycl if you're able to or if your tetracyclin are contraindicated aryin or eamy so what are the contraindications for doxic cycling so obviously if you're hypers sensitive to it or any component of the preparation or any other tetracyclin of course same family uh kids under 12 pregnant or best feeding patients and those with renal or hepatic impairment yeah nice so that was super quick let me just come out of this and yeah Grand so yeah nice little Whistle Stop tour of what to expect an exam hopefully that has been useful for you guys um like I said I wasn't treating it like a a mock exam I just wanted to give you a flavor of what to expect what the questions would be like Etc so does anyone have any questions about any of the cases or anything to do with the exam in general I think for the Dr cyclin it's quite important um um the dose is probably 20 milligram or 40 milligram and I think um I don't know whether you may have a questions like that but basically you you you get people with rosaia where you almost have to keep them on very long term not only three months and they almost take a holiday when they go for a sunny holiday because effectively get photosensitive rash so they can take a break and then then they they start back again uh for doxic cycling um I think um if you I mean I've I've got another presentation I can give you I mean I I can carry on for another hour if you want I'm very happy to give you another uh presentation but if You' got any questions related to what CLA has eloquently presented I think that'll probably be probably more useful for you at this stage yeah because I think like after I mean my friends sat the exam were mainly talking about how different we thought it was and how it did it rattled us right before we even started because we weren't expecting the strictness of the invigilation we weren't expecting to have to show a room you know people might have their pants hanging up somewhere and they're suddenly embarrassed by it um or like you know I've got my dog with me they maybe don't think about things like that um so I thought you know it' be quite useful for you guys just to kind of get an idea of what to expect but it is fine it's it's actually fine you know every single person that I know that's gone through this exam you know they've done really well with it and yeah it just it comes across as being really intimidating because you put in all this hard work I mean this is one of the most difficult things you're going to do in your career you go through the uni course and then you've got the hospital placement to do which is huge and then you've got just one day to prove that all of that was worth it and prove that you've learned so much and it's a bit unfair in a way because it's not true to life you know a lot of the things that you're going to answer in the exam is not how you're going to treat people like what sanre was saying there you're going to do things that are a bit off the books um but yeah just be confident just be confident that you know your stuff and you're going to pass and you're going to be amazing IP opts and it's it's really really rewarding what you can do when you're qualified you know taking the strain off the hospital is massive but also for your patients you know it's just it's so much nicer to be able to treat a lot of these conditions in the community and not worry them by going to the hospital and not stress them with waiting list things like that so yeah it'll be all all worth it in the end Claire can I ask a question yeah of course I I was just wondering how often did you use your BNS like when you sat your exam like did were you feeling like you had to like check it quite a lot or did you just have on the side yeah so I checked it quite a lot um because like I was saying I didn't memorize all the side effects um just didn't have the time um to do all of that so yeah um probably used at about 25 30% of the questions probably good but yeah I did find that useful to put little sticky notes in the sections I thought that I would look at so just section of UTIs hery Simplex glucoma just so that you can quickly find them good and and also just another quick one this might sound a bit silly but um see on the Optometry formula for the stero all the steroid um treatment in the automet formula it keeps saying that and like it has a warning it says steroids should normally only be used for a maximum of one week but obviously for us we know that we're like doing it for like six I take it we just assume that we don't have to worry about that yeah 100% so the cmgs will tell you that you taper it over six weeks so when you're answering purely in the cmgs even the cmgs tell you that so just wanted to double check okay I know and it is no you're very welcome it is it's things like that that when you're trying to study and memorize everything by rot you look at it and you go well that doesn't make sense you know they're saying one thing but SE another so yeah don't worry about questions like that we've got a question on the chat box which is um somebody saying that they hadn't realized how much they would need to know about the side effects um do they also need to know all on the formulary College list I hope that makes sense I'm going to say yeah so yeah but that's what your BNF is for you know it's there's no way that you're going to be able to memorize every single drug and every single side effect and that's not what happens in real life you know when I'm discussing with patients like if I'm putting them on something I do have to pull up you know the BNF and go you know what I've totally forgot about this but let me just run through the side effects with you um so yeah that's what your BNF is going to be useful for in the exam C could I ask a we question if that's okay yeah go ahead and obviously we've been plowing through these cmgs for what what feels like forever now for this exam preparation and there is a lot of them and obviously there's the main ones like uus hsk that the big ones that you think will probably most likely be in it did you find it it tended to be the more sort of Ip ones that were in it or was some of the more obscure ones like I mean there's on CMG on like macular traction and H the more did you find it more IP type ones definitely more the IP type ones um I had one that was non IP and I cannot for the life of me think what it was it might have been something like the vacular traction one it might have been something retinal but I thought that might have been a pilot question because for me I thought well why you know I'm not prescribing for anything here why are they asking me this um but we did we asked the college before we sat our exam back in 2021 because we were quite worried about all of the pigmented conjunc lesion cmgs all things like that and the college gave us a a very basic answer they just said look we're going to ask you any CMG so likely it's going to be IP related stuff but they might ask something about out there thank you does anybody else have any questions that they want to ask or or is everybody just desperate to go and get the dinner now or oh we've got one here um so the pilot questions are scattered amongst the order and they're not all at the end oh no so you will not know you won't know where when they're going to turn up they're just going to be random so it's not as if it's like 75 real and then here's 10 fake questions they're not going to tell you when they're Pilots um the whole purpose of a pilot is they want to see if they can use that question in the future so as much as you're not going to be assessed on a pilot question they're going to look to see how many of you will pass that question and if a good proportion of you pass then they can use that in a future exam okay anybody else anym now's your chance and yeah if if there's any you know if you guys think of any questions after so after this webinar you can email them to Louise and Louise can fire them off to me and I'm more than happy to get back in touch with you guys if you need anything is there much on glucoma in the exam 10% so 10% of your question are going to be based on gloma that's not bad actually because as you said initially it was very heavily weighted on glaucoma and I think it's probably ruc to 10% which used to be 33% so used to be a third wow we've now got one asking are the qu are there are there questions which show us ocular images or is it all worded questions I honestly can't remember I can't remember if I had any pictures I'm going to say it's worded yeah but don't hold me to that because I cannot remember now I think it's worded were there any questions asking about the incidents or prevalence of the conditions there could be there certainly could be yeah which is not making it easy for her she would have thought last seven days I need to do this one need to do that I know it's always the question you know you always look at something and go I'll never need to know that and then it's the first question that appears and you think okay here we go good um I think um from the sounds of it um Claire you've covered it really well um first of all thank you very much for sharing your um experience and I hope it was useful for all you guys from my point of view all I can do is wish you all well and um all the best for the exam good luck you'll be absolutely fine good luck everybody um you will get CPD for this if you complete your feedback form I'll send these out tomorrow or Friday um and once I get your responses I can issue with um the certificate of attendance um so if you I may not get the certificate to you within the next day or two but I'll get them over the next few days um good luck and as CLA said if you've got any questions you know when you go away from here tonight if you think oh should have asked this or I'd like to just know a little bit more about that please just feel free to email me and um I'll get those questions over to Claire and we'll get a response to you as quickly as we can okay um but good luck you're all going to be fantastic I'm sure oh we're having good luck thank you from Devon so yeah that's um good on the [Laughter] D but yeah I'm amazed at how many people have come along from so many different places it's great it's nice to have new people so right okay luck good luck everyone good night good night bye bye thanks CLA bye thanks CLA thanks sanjie bye [Music] bye