Urology - FEBU Oral Examination
The FEBU oral examination is a structured case-based viva. Examiners present clinical scenarios and ask you to reason aloud: interpret the information, prioritise, justify investigations, and propose management. It is not a rapid-fire fact test; it assesses whether you practice safely, communicate clearly, and know when to escalate.
What examiners assess
- A reproducible clinical method: stabilise, diagnose, stage/risk, treat, follow up.
- Prioritisation in emergencies and recognition of must-not-miss diagnoses.
- Investigation sequencing: each test should change a decision.
- Guideline concordance and awareness of alternatives, including MDT pathways.
- Communication: consent, shared decision-making, breaking bad news, and acknowledging uncertainty.
Core rules
- State the diagnosis and the key differential before planning.
- Answer the exact question; if asked "what would you do next", give one concrete action and a rationale.
- In oncology, state stage and MDT discussion before treatment; mention fertility, sexual function, and diversion.
- In emergencies, name the time-critical step (decompression, antibiotics, detorsion, resuscitation).
- Offer alternatives and contraindications; do not present a single option as universally correct.
- If information is missing, ask for it rather than inventing it. Summarize the plan and follow-up at the end.
Worked example
A 70-year-old man has cT2N0M0 high-grade muscle-invasive bladder cancer and is fit for cisplatin. The examiner asks: "How would you manage him?" Reasoning: first confirm the staging and histology, then discuss in MDT. For fit patients, neoadjuvant cisplatin-based chemotherapy followed by radical cystectomy with pelvic lymphadenectomy is standard; radical radiotherapy is an alternative. Discuss urinary diversion and sexual/fertility implications. Do not offer TURBT alone with curative intent. Show the sequence and the reason for each step.
Traps that cost marks
Jumping to surgery without staging or MDT; giving a management list without prioritisation; failing to mention alternatives or contraindications; ignoring comorbidity and patient preference; being unable to justify an investigation; and becoming defensive when challenged. Also, not asking for missing information.