Sunday, March 9, 2008


I've not had a chance to update this blog for a couple of weeks - mainly for positive reasons. My work ethic has changed and I've moved up a gear or two now. I find as the exam looms, I start putting more and more pressure on myself to work, and it drives me to put the hours in. The motivation comes from imagining that feeling of seeing your number up on the board in the College telling you that you've passed: I don't want it any other way! Don't get me wrong, I still feel like there's too much to do in too little time, but its now about playing the game.

There's no way around the MCQ paper: you have to practice and practice and get into it's mindset (sounds very psychological I know!). I think it's vital to complete all the College MCQs as there is a high chance that a couple will appear in the exam - free marks if they do. I've almost finished the 240 MCQs in the College book, and am averaging between 40-50% which I'm encouraged by at this stage.

The SAQ paper is all about structure: it is possible to pass a question without intimate details e.g. "How would you anaesthetise XYZ......?". Now, you may not know much about paediatric craniofacial surgery, or even seen it.......BUT you can answer the question. Write down what you would actually do: start with an introduction - shared airway, other potential congenital abnormalities, paediatric anaesthetics blah blah. The preop, periop, postop. Then you would go and see patients, rapport, consent, history, exam, investigations, +/- premed. Emergency equipment & drugs, skilled assistance, venous access, O2, monitoring (AAGBI), senior help, induction - drugs (+doses in mg/kg NOT actual doses) & airway, maintenance, analgesia, post-op etc. I know its a simplified version, but if there is a system which is the same for any question, you will not miss anything out......and you will pass the question. It is all about demonstrating to the examiner that you are structured, organized, and above all you are SAFE!

I've been working my way through the past SAQ papers published on the RCOA website. Interestingly enough, in recent years, there have been two questions repeated almost identically the year after. I believe in October 2005, there was a question about a 15yo having surgery for idiopathic scoliosis, repeated in October 2006. Same for NIBP measurements in May 2006 and May 2007. Obviously, I'm not advocating question spotting as a substitute for the work, but there is definite benefit from having been through these recent papers!

Further to my previous posting on review articles and SAQs, I think the value lies in trying to have a look at review articles from the previous 2 years prior to exam setting. Which means, for this April sitting, essentially all of the articles of 2006/2007, and possible the beginning of 2008. No mean feat! There are a lot of them! Reasoning behind this method of madness, confirmed to me again yesterday whilst going through October 2006 paper. There is a question on Awareness during GA, and in November 2005 there was a lovely review article published in CEACCP on......yes, it was Awareness.

PS/ don't forget to look at your basic sciences for the SAQs/MCQs as well. In May 2007, there is a question on Microshock, and the NIBP question.

1 comment:

AF said...

Other things that seem to come up in the exam with frightening regularity are things which have had one of the following published about them in the previous 12 months:

AAGBI guidelines
NPSA guidelines
NICE reports
NCEPOD reports.

So things to watch out for this year include:

Obesity/morbid obesity
MH guidelines (updated) (AAGBI)
Local Anaesthetic Toxicity (LipidRescue/Intralipid) - see (AAGBI)
Consent (Mental Capacity Act 2005 in force from October 2007)
Management of analgesia in labour (NICE guideline on management of Intrapartum care)

Also, watch out for another question on awareness, as there is a film about to be released called "Awake" ( in which Hayden Christense wakes up during his operation (cardiac, of course) and overhears plans to murder him (or something) - due for UK release 4th April! There was an article about awareness in the Sunday Times or Times2 some weeks ago on the back of this film.

Hope to meet you at Mersey Booker in a couple of weeks, you're blog is helping me keep a realistic perspective!