How to Do the FSP Vorstellung? (Patientenvorstellung)

The third part of the FSP, the Patientenvorstellung, is where you present the information you gathered in the Anamnese to a colleague — the Oberarzt or the examining board — verbally, in a structured, medical register. There is no patient here anymore; a physician is sitting across from you. So the language changes too: where you said "Atemnot" to the patient, you say "Dyspnoe" to your colleague. This part looks short, but it's where most points are lost in the FSP — because most candidates study the words, not the structure.

1. What is the Vorstellung, and why are the most points lost here?

In the Arzt-Arzt-Gespräch (the doctor-to-doctor conversation), what's expected of you is to introduce the patient in five minutes with a clear chain of reasoning: who is this patient, what is the chief complaint, what came out of the Anamnese, what's on examination, what you suspect, and what you'll do next.

Most candidates get stuck here for three reasons:

• No structure: the information pours out in whatever order it comes to mind, and the listener gets lost.
• No Konjunktiv: you relay what the patient said as if it were your own observation — a grammatical and logical error.
• No plan: the Verdachtsdiagnose is stated, but at "so what do you want now?" you fall flat.

Important: the board isn't looking for fluent German here. You can have an accent, and small mistakes are forgiven. What they're after is structure + correct terminology + confidence. A scattered but fluent candidate scores lower than a structured but halting one.

2. Structure and sequence — the skeleton you must memorise

A good Vorstellung always follows the same backbone. Make this sequence a reflex; in the exam you should move from one step to the next without thinking:

1. Personalien — the patient's name, age (sex/occupation if needed).
2. Hauptbeschwerde — the chief complaint, in a single sentence.
3. Jetzige Anamnese — the history of the present complaint (onset, character, course).
4. Vorerkrankungen — known past illnesses, operations.
5. Familienanamnese — significant illnesses in the family.
6. Sozialanamnese — occupation, smoking/alcohol, living conditions.
7. Vegetative Anamnese — fever, appetite, weight, sleep, urination/stool.
8. Körperliche Untersuchung — examination findings (if any).
9. Verdachtsdiagnose — your leading diagnosis.
10. Differentialdiagnosen — differential diagnoses (2-3 of them).
11. Diagnostisches Vorgehen — which investigations you'd order.
12. Therapeutisches Vorgehen — your initial treatment/management plan.

Practical tip: shorten these 12 steps onto a sheet of paper and jot notes beside them during the Anamnese. When you move to the Vorstellung, this skeleton becomes your map — you'll see which step is still blank.

3. Ready-made phrases (make them a reflex)

Memorise one or two fixed phrases for each step; fill in the rest according to the patient. The most useful ones:

4. Why is Konjunktiv I critical?

This is the technical heart of the Vorstellung. When you relay to your colleague something the patient told you, you must present it as the patient's statement, not as your own definite observation. German does this with Konjunktiv I (reported speech / indirekte Rede).

The logic is this: saying "the patient has abdominal pain" implies your diagnosis; whereas all you actually know is that they said so. The Konjunktiv preserves this distance — and the board counts it as a sign of maturity.

The distinction: everything the patient said is relayed in the Konjunktiv. But an objective finding you saw on examination (Indikativ) is stated plainly: "Das Abdomen war druckschmerzhaft." The patient says → Konjunktiv; you see → Indikativ.

5. Time management and what the board is looking for

The Vorstellung is usually 5-10 minutes. Most of the time they let you speak without interrupting, then go deeper with questions ("Welche Differentialdiagnosen noch?", "Warum dieses Medikament?"). Split the time like this:

• First half: Personalien → Anamnese → examination (a fluent, uninterrupted narrative).
• Second half: Verdacht → DDx → diagnostics → therapy (this is where you show your thinking).
• The ending: a one-sentence "Zusammenfassend …" summary — it wraps things up and closes strong.

The real criteria in the board's notebook:

• Structure: did you follow the steps in the right order?
• Terminology: did you switch from patient language to medical language? ("Myokardinfarkt", not "Herzinfarkt")
• Logic: are the Verdacht, the DDx and the plan consistent with each other?
• Confidence: when a question comes, can you defend it and give a reason to "Warum?"

A striking truth: fluency is at the bottom of the list. A halting but structured presentation reads, in the board's eyes, as "a physician I could trust on the ward." That's the real test.

6. Common mistakes

• Slipping into Laiensprache: saying "Bauchweh", "Zuckerkrankheit" to your colleague. This is a doctor-to-doctor conversation — say "Abdominalschmerzen", "Diabetes mellitus".
• A scattered sequence: stating the treatment first and then going back to the diagnosis; squeezing the vegetative history into the middle of the examination. Break the skeleton, lose the board.
• Forgetting the Konjunktiv: stating every patient statement in the Indikativ — the most common grammar mistake, the distinguishing detail.
• Skipping the DDx: stating a single diagnosis and stopping. Always add 2-3 differentials; the board measures the breadth of your thinking here.
• Finishing without a plan: saying "Verdacht ist Appendizitis" and falling silent. Always continue with "Zur weiteren Abklärung würde ich …" — without investigations and treatment the presentation is half-done.
• No summary: stopping abruptly. A one-sentence "Zusammenfassend …" at the close frames the presentation and makes it look professional.