The Four Questions That Really Matter in Psychiatry – Pass the RANZCP Exam OCI/MOCI

4 questions that matterLast week we held the OCI / M-OCI course for registrars and exemption candidates for the RANZCP Exam. I named it “Clinical Formulation and Patient Management Masterclass”. That’s because, it really isn’t just about the exam, it’s about the patients for whom we want to make a difference. It was a great turn out of motivated and enthusiastic candidates. Over the last 4 years of teaching large groups and imparting a structure for psychiatric formulation and management, I asked myself…….Is there a way of simplifying the assessment to lead to a comprehensive formulation and management plan? Finally, I think I have the answer.

The Four Questions That Matter in Psychiatric Practice

  1. What is/are the problem(s)?
  2. Why has the patient developed the problem?
  3. How do I solve the problem?
  4. What resources do I have and what barriers will I face? ( Ok….I see this is two questions in one, but you get the point.)

Divide all the above into bio-psycho-socio-cultural elements and voila, you have elements for a comprehensive formulation and management plan. One tip though…….Your vision must be getting the patient back to as complete a recovery as possible and don’t forget the patient’s aims and aspirations. Have a look at this article and this one (Formulation; the Sherlock Holmes Way) for further tips on psychiatric formulation and management.

Try it out, it works a treat for me in practice. Let me know what your questions are?

This article is written by Dr Sanil Rege. Sanil is a Consultant Psychiatrist in Mornington and co-founder of He is pursuing an MBA at the Melbourne Business School.  You can follow him on Google+

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