Advances

In response to a comment on the last posting: the podcasts can be found on the itunes store if you search for: Anatomy & Physiology Advanced and also for thegascast.

I received a phonecall today informaing me that I had been bumped up from the reserved list for the Mersey Booker course to actually having a place now on the course which is a complete bonus (albeit an expensive one). There's nothing like forced MCQs/SAQs and lectures to focus one's mind!!

I did my first SAQ paper today from the Royal College past papers. It wasn't strictly timed and I had to give up on a couple of questions but at least it's a start. I found that I could offer a reasonable amount of quantity but I need to structure the answers better; hopefully this will improve with practice!

A colleague has presented me with an excellent suggestion which was recommended to him by a previously successful candidate. I fully recommend following this principle. From today onwards we will email each other SAQs, write an answer within 15 minutes and email it back to be marked by the other. By gradually building up the number of questions done, the practice should increase exponentially. The answers can also be done during a lunch break at work.

I've also been invited to an informal SAQ evening tutorial session every Monday where possible with three other colleagues. A consultant anaesthetist is heading up the tutorial, and previous paper's answers & structures are marked and discussed. Again, if not already done, I would recommend this strategy of exam practice.

Something else which came to my attention over the weekend whilst on call on the Neuro ITU, and also during a lecture last week from a previous finals examiner, was the subject of paper setting and journals. It has been stated that a few of the SAQs are taken from review articles and journal publications over the previous couple of years. The main journals to keep an eye out for, I believe, are: BJA (including CEACCP & Bulletins), Anaesthesia (including the supplements), Anaesthesiology, and Critical Care Medicine.

The fear

I officially today got what is universally known as "the fear". No precipitating factors really; we had a teaching session with a practice SAQ and I struggled to organise and structure my questions. My colleagues always appear to have much more confident and well-organised answers. I know and hope this is just my own insecurities leaking out but I really need to concentrate on understanding what the question is asking and structure accordingly. I had that feeling today of running out of time - where there appears to be so much still to do with not a lot of space to accommodate it all.

I started some MCQs the other day from MCQs in Anaesthesia by Ganado (see previous post with book listings. The explanations for the answers given in this book are superb - almost like a mini-textbook in itself. The first 20 MCQs I did, I scored 50% and was delighted; falsely so!! The next 20 MCQs scored 35%. As usual with commencement of MCQ practice it can be variable, usually with some confidence-draining scores at the beginning. One of the positive factors I took from the Primary exam was that I know I am a good MCQ guesser. This is an important fact that you should know about yourself when preparing for MCQs. Some people are naturally good guessers; other are not. One way of finding out if you have not already done so is to do a number of MCQs e.g. 25-50. Whilst you are doing them, number each answer from 1-3, where 1 is "I'm positive I know that this is the correct answer"; 2 is "I think this is the correct answer but can't be totally sure"; 3 is "This is a complete guess". Mark the MCQ and count up the number of 1's, 2's, and 3's. If you're getting lots of 2's and especially 3's as correct answers, you are likely to be a good guesser and should probably make more educated guesses in the actual exam, rather than leaving questions out due to the negative marking. Chances are that with this strategy, you will gain a higher mark than if you omitted the question.

Bizarrely, whilst browsing some podcasts on the itunes online store, I found some advanced Anatomy & Physiology tutorials by an American clinician (Dr M Bonner). Rather sceptically, I downloaded them to my Ipod and have been playing them in the car to and from work this past week. Despite a few Americanisms and some dodgy intro and exit music, surprisingly, I have found them quite useful. They do go right back to the beginning in some subjects but to listen passively whilst driving and brushing up on some basic science, I think, has made pretty good use of commuting time.

Getting Serious!

I haven't had the chance to write anything for the last four weeks or so due to moving house. We didn't have broadband for the first two weeks and dial-up internet is so painfully slow. I had to take a week off revision for the move and have only just started to build it up again. I'm ploughing through Clinical Anaesthesia/Specialties/Trauma etc which seems to be the largest section for reading in text books. I still haven't really made notes as such, apart from the odd revision card for stuff I can never remember. When I was doing the Primary, I made so many notes yet never ended up using them (I think I still have Parbrook in my note form somewhere). People will probably argue that it is the act of writing the notes which aids the learning; for some this is true. I have found that for me it is repetition of material that works i.e. reading it again and again so it finally sticks.

I have been extremely lucky with my rotation so far at the Huge Teaching Hospital, as I will have had some experience in some of the major specialties by the time the exam is reached i.e. Cardiac, Paediatrics, Obstetrics, Neuroanaesthesia, ICM. Again for me, learning by seeing cases and performing the relevant anaesthesia under expert supervision and teaching has helped me no end, especially when it comes to clinical cases. They also run regular and rather daunting viva sessions in front of your colleagues - yes, I know it makes the exam experience easier, but it still doesn't help when your colleagues realise you have forgotten everything about Malignant Hyperthermia!!

I start my Neuro ICU nights this week, so cannot really estimate how much work will get done as I have a presentation to prepare and an audit to write up as well. My aim is to finish reading Clinical Anaesthesia within the next week and then the dreaded Basic Sciences will make a return! This time I have Bricker's 'The Anaesthesia Science Book' at my disposal so will again divide my time between Physiology, Pharmacology, and Physics/Clinical Measurement using this textbook, referring to my Primary notes/Parbrook/Peck & Hill etc. I'm also starting some MCQ practice this week. There is a tendency to concentrate on the SAQs at the expense of MCQs - I don't find doing MCQs as mentally taxing as the SAQs so at least it will bring some variability into the work now.