Practical Guide for Junior Doctors

Presenting a gastro patient well is not about listing every blood result.
It’s about showing that you:

Understand the problem
Recognise severity
Know the risks
Have a plan

A good presentation should take 30–60 seconds, not 5 minutes.

This guide focuses on clear, structured, safe ward-round presentations in real NHS practice.

✅ First principle

Always present in this order:

👉 Who → Why here → How sick → Key data → Plan

If you follow this structure, you’ll sound senior automatically.

✅ The Universal Gastro Presentation Structure

Use this for almost every patient:

1. One-line summary

2. Current issue / diagnosis

3. Clinical stability

4. Key findings (only important ones)

5. What has been done

6. Clear plan

🟢 The 30-second template (copy this)

“This is a 58-year-old man with alcohol-related cirrhosis admitted with ascites and possible SBP. He is currently haemodynamically stable. Ascitic tap showed neutrophils 600, so we started IV antibiotics and albumin. Renal function stable. Plan is to continue antibiotics, monitor U&Es, and await cultures.”

Short. Safe. Consultant-friendly.

📌 Step-by-step breakdown

1. Start with a one-line ID

Who + key background

Examples:

“65-year-old with cirrhosis”
“Young lady with Crohn’s”
“Known gallstones”
“Background alcohol-related liver disease”

Avoid:
❌ reading the whole PMH

2. State why they are here (main problem only)

Examples:

UGIB
Ascites
IBD flare
Pancreatitis
Abnormal LFTs

Not:
❌ 5 minor problems

Think:
👉 What problem got them admitted?

3. Say how sick they are (very important)

Consultants want this first.

Include:

Stable vs unstable
NEWS
Oxygen
Haemodynamics

Examples:

“Currently stable, NEWS 1”
“Tachycardic but normotensive”
“Improving clinically”

This shows risk awareness.

4. Give only key results (not everything)

Only include results that change management.

Good:

Hb dropped
CRP rising
Creatinine worsening
Bilirubin high
Neutrophils >250

Avoid:

❌ listing every number

Bad:
“ALT 68, AST 59, ALP 122, bilirubin 21…”

Nobody cares about minor details on WR.

5. Say what has been done

Shows you are proactive.

Examples:

Started IV antibiotics
Given fluids
Ascitic tap done
Started steroids
MRCP arranged

6. End with a clear plan

Always finish with:
👉 “Plan is…”

This makes you sound senior.

Examples:

Continue antibiotics
Repeat bloods
Gastro review
Imaging today
Discharge planning

Never finish without a plan.

✅ Condition-specific examples (very practical)

🟡 Ascites / Cirrhosis

“52-year-old with alcohol-related cirrhosis admitted with tense ascites. Stable. Ascitic tap negative for SBP. Renal function normal. Plan is diuretics, fluid balance, and consider LVP.”

🔴 UGIB

“70-year-old admitted with melaena. Haemodynamically stable after fluids. Hb dropped from 120 to 88. On IV PPI. Awaiting endoscopy today.”

🟢 Pancreatitis

“45-year-old with gallstone pancreatitis. Stable. Pain controlled. CRP 90, renal function normal. On IV fluids. Awaiting ultrasound.”

🔵 IBD flare

“30-year-old with ulcerative colitis flare. 8 bloody stools/day. CRP 110. Infection screen pending. Started IV steroids. Monitoring closely.”

✅ What consultants actually want to hear

They care about:
✔ Why admitted
✔ How sick
✔ Any complications
✔ What you’ve done
✔ What you want next

They do NOT care about:
❌ every blood result
❌ entire history
❌ medication lists
❌ irrelevant info

❌ Common mistakes juniors make

Reading the whole notes
Giving every lab value
No structure
Forgetting severity
No clear plan
Talking too long

If it takes >1 minute → it’s too long.

✅ Golden rule

If your consultant interrupts you, you’re giving too much detail.

Short and structured wins.

✅ Take-home concept

A good gastro presentation is short, problem-focused, and ends with a plan.
Show you understand the risk, not that you memorised the notes.