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Notes and time management in the FSP: a 3 × 20-minute template

In short

In almost every chamber you may take handwritten notes during the doctor–patient conversation; paper and pen are usually provided. The notes are not graded and in several chambers are collected at the end — and they are your only source for the documentation form in part 2 and the case presentation in part 3. Westfalen-Lippe, Lower Saxony, Bavaria, Berlin, Baden-Württemberg, Saxony and Thuringia explicitly allow them in part 2, Westfalen-Lippe and Lower Saxony also in part 3. If you structure your notes like the form, you can transfer them one to one in part 2.

What the chambers say about notes and aids

Chamber Notes in part 1 Explicitly allowed in Part 2: medium and aids
Westfalen-Lippe yes, paper and pens provided parts 2 and 3 Berichtsbogen (report form), by hand or on a PC; medical dictionary
Lower Saxony yes, paper provided parts 2 and 3 Aufnahmebogen (admission form), “handschriftlich und leserlich” (by hand and legibly); medical dictionary
Bavaria yes, writing materials in the room part 2 structured template, laptop or by hand
Berlin yes part 2 structured template, computer or by hand; medical dictionary
Baden-Württemberg yes part 2 Anamnesebogen (history form); medical dictionary
Saxony yes, also in your native language part 2 structured form; medical dictionary, no other aids
Thuringia yes part 2 report in full sentences; medical dictionary
Nordrhein blank notepad and pen not explicitly regulated Anamnesebogen; no other aids
Hamburg notepad and pen not explicitly regulated by hand on a prescribed form; no other aids
Hessen yes, paper provided, bring your own pens (no pencils) not explicitly regulated Anamnesebogen; no aids

The notes are not graded (stated explicitly by Westfalen-Lippe, Lower Saxony, Nordrhein, Hamburg and Saxony-Anhalt); Westfalen-Lippe, Lower Saxony, Bavaria and Berlin collect them at the end. Your own aids are not allowed; Westfalen-Lippe and Lower Saxony write: “Mobiltelefone, Gepäck oder Hilfsmittel dürfen nicht in die Prüfungsräume mitgenommen werden” (mobile phones, bags or aids may not be taken into the exam rooms). Where a chamber does not explicitly regulate using the notes in part 2 or 3, ask at the briefing rather than assuming. Brandenburg asks you to bring “Kugelschreiber oder Füller” (a ballpoint or fountain pen), Hessen your own pens.

Only Saxony explicitly allows notes in your native language (“gegebenenfalls auch in Ihrer Muttersprache”). German keywords still save time: you write the form in German anyway.

The note template: transfer one to one

The chambers' documentation forms are similar. Nordrhein asks for the patient (first name, surname, date of birth), reason for admission, Allergien/Unverträglichkeiten (allergies/intolerances), Genussmittel/Drogen (substance use), social and family history, then suspected diagnosis, differential diagnosis, further diagnostics and therapy proposals. Lower Saxony adds age, height and weight and asks on page 2 for a report “in ganzen Sätzen” (in full sentences). The Mainz form also has fields for place of residence, GP, occupation, marital status, children, vegetative history, mental state, medication and gynaecological history. The template covers all of these fields — every item sits where the form asks for it (more on the form under Documentation).

Divide the first page of the pad into zones and write the abbreviations down the left margin. A Munich candidate reports writing his scheme vertically on the scrap sheet before the start; whether your chamber allows that, you will learn at the briefing.

Zone What you note Ends up on the form under
Pers. name (spelled), date of birth, age, height, weight, GP Patient/in; age, height, weight
LS (Leitsymptom, main symptom) onset, site, radiation, character, severity 0–10, course, triggers, relief reason for admission; history
BS/Veg accompanying symptoms; fever, weight, appetite, bowels, urination, sleep, night sweats; for women last period, contraception, pregnancy history; vegetative and gynaecological history
VE/OP illnesses, operations, accidents — each with the year or age history; previous illnesses and operations
Med name, strength, scheme (1-0-1), as-needed medication, over-the-counter products history; medication
All trigger → reaction Allergien/Unverträglichkeiten
Nox cigarettes per day and since when, alcohol per day or week, drugs Genussmittel/Drogen
FA who, which illness, at what age, deceased if so family history
SA occupation, marital status, children, living situation social history
F the patient's questions and your answer; tests discussed part 3; in Mainz “Mit dem/der Pat. besprochene Untersuchungen” (tests discussed with the patient)
Ich your own thoughts: suspected diagnosis, DD, diagnostics, therapy suspected diagnosis, differential diagnosis, further diagnostics, therapy

Two rules make the template reliable:

Example: filled-in notes

Example — fictional case (the patient from the sample dialogue under History taking). The notes stay in German, as in the exam:

In English: abdominal pain since yesterday lunchtime, starting dull around the navel and moving to the lower right overnight, now stabbing, worse with jolting, 7/10; 38.2 °C this morning, nausea, vomited once, no appetite; no previous illnesses or operations; the pill and one ibuprofen of unknown dose; penicillin allergy with rash; questions about appendix, surgery and eating, each answered.

Abbreviations and symbols for fast notes

Abbreviation Meaning Abbreviation Meaning
Ø no, denied, none + present, yes
↑ / ↓ increasing / decreasing → radiates to, leads to
? unclear, ask back „…“ the patient's own words
! important, warning sign × times (2× tgl. = twice daily)
1-0-1 morning–midday–evening b. B. bei Bedarf (as needed)
J. / Mo. / Wo. years / months / weeks LJ Lebensjahr (year of life)
re. / li. right / left OB / UB upper / lower abdomen
VE Vorerkrankungen (previous illnesses) Z. n. Zustand nach (status post)
V. a. Verdacht auf (suspected) DD differential diagnosis
Med. / All. medication / allergies Nik. / Alk. nicotine / alcohol
py pack-years FA / SA family / social history
LP letzte Periode (last period) SS Schwangerschaft (pregnancy)
T temperature HA Hausarzt/Hausärztin (GP)
o. B. unremarkable F the patient's question

These abbreviations are for your notes only. On the form, write words out and use only standard abbreviations such as “V. a.” or “Z. n.” — more under Lab values and abbreviations.

Time plan for 3 × 20 minutes

The chambers set the length of each part, not how you divide it. The plans below are therefore suggestions for the standard format. Your phone may not go into the exam room (Rhineland-Palatinate explicitly mentions smartwatches too); whether there is a clock in the room is not stated in the chamber information reviewed here — in the Munich protocol there was one on the table.

Part 1: doctor–patient conversation

Minute Goal Zone
0–2 greeting, introduction, personal details (spell the name, date of birth, height, weight) Pers.
2–8 current complaint, symptom and pain history, accompanying symptoms LS, BS
8–10 vegetative and, if relevant, gynaecological history Veg
10–14 previous illnesses, operations, medication, allergies, substance use VE/OP, Med, All, Nox
14–16 family and social history FA, SA
16–17 summary with a check-back question —
17–20 suspected diagnosis, tests and how they work, remaining patient questions F, Ich

Answer patient questions immediately, whenever they come. If you are still on the main symptom at minute 10, move on: the Munich protocol advises not to keep chasing the diagnosis after 10–12 minutes but to cover the remaining blocks.

Part 2: documentation

Minute Goal
0–2 review your notes, match the zones to the form's fields; add nothing that was not said
2–5 header fields: name, date of birth, age, height, weight, allergies, substance use, social and family history
5–13 history in full sentences, patient statements in Konjunktiv I (reported speech)
13–17 suspected diagnosis, differential diagnoses, further diagnostics, therapy — using medical terms
17–20 proofreading: name and date of birth, numbers and units, word order, Konjunktiv

If you write on a computer (optional in Bavaria, Berlin and Westfalen-Lippe; mandatory in Brandenburg, Mecklenburg-Vorpommern and Saxony-Anhalt), plan the same way — but Saxony-Anhalt points out that no spell-checker is available.

Part 3: doctor–doctor conversation

Minute Goal
0–3 case presentation: personal details, reason for admission, history, suspected diagnosis, DD, planned next steps
3–15 questions and discussion: details from the conversation, reasons for the DD, diagnostics, explaining a procedure
15–20 terminology task, if your chamber sets one

No chamber publishes how long the terminology task takes; expect it to fill the last few minutes. Its scope: Berlin 5 terms, 2 abbreviations and 3 lab values; Hamburg 15 terms; Lower Saxony 12 in both directions; Westfalen-Lippe and Thuringia a short list. Your notes are in front of you — use them rather than guessing details from memory (more under Doctor–doctor conversation).

Deviating formats

The fsppruefung.de simulator has a notepad during part 1, and you write part 2 on a chamber-style documentation form — so you practise exactly this transfer under time pressure.

Sources

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