Sunday, June 22, 2008

This is it.....

Well, nearly seven months have passed, and it all comes down to eighty minutes or so tomorrow. I've reached the stage today where I am not really able to do much more. Shortly, I'll be heading off to London to stare at the hotel walls for a few hours and follow the usual pre-exam routine of trying to read stuff but not really achieving much.

I've usually found that having done the exam, everything I've read would have made no difference anyway, but I'm still holding onto my earlier piece of advice re: keep reading.

Best of luck to everyone taking the exam this week - I'd like to think that if we've put the work in and done the viva practice, we deserve to pass this marathon! Thanks to all who've left messages of support on this blog: nice to know that there are others sharing the pain. Looking forward to a pint or two tomorrow afternoon in the Square Pig - come and find me, I'm easy to spot: tall with red hair!!

Friday, June 20, 2008

Stir Crazy

Does the below sound familiar?

-Frantically trying to read a whole textbook in one day?
-Random A-Z hopping?
-Reading the same sentence six times and then wondering what you have just read?
-Panicking because of failure to retain the new clotting cascade?

Enough is enough and, whilst going completely mad on my own in the house trying to achieve the above may seem like the only way forward, I have to try and preserve some sort of sanity and order. So, here is the well-meaning plan for the next two and a half days:

-Concentrate on some clinical viva stuff for the rest of today and part of tomorrow. To break it up, I will do some "light-hearted" revision of ECGs and X-Rays/scans.

-Tomorrow, I will look at topical stuff: this includes guidelines (found earlier in the blog), resuscitation algorithms (you never know - would be embarassing to stumble here!), and a quick scan at the Bricker SAQ book. I will break this up with some more "light-hearted" diagram drawing practice from both the A-Z and my notes.

-This leaves Sunday free: I will go through the RCOA guide (both old and new - received two days ago by post), as colleagues have had vivas straight from this guide in the past. I will also re-re-re-re-re-revise some anatomy and probably try and learn how to draw inhalational agents, including their SVPs etc. I'll probably read through this blog as well just for good measure!

Tuesday, June 17, 2008

The Final Countdown

We're nearly there! Anyone done any A-Z chasing (see previous posting re: flipping through the holy book of Anaesthesia from topic to topic? - Guilty as charged!! My rollercoaster week continues - some days I feel I am going to nail this exam. I'm going to walk in and from the start be confident, articulate, and present my text-book knowledge in a concise, yet structured manner. Other times, I look blankly at my viverer, my mouth dry, and my brain even drier - a feeling of hopelessness overwhelming. I have discovered a new phrase: "The £680 answer - an answer so disorganised or dangerous that it will precipitate a return to the College when the leaves are brown!!

I've been pretty lucky and had a lot of viva practice. I've also had a lot of excellent advice from both Consultants and Registrars alike:

There is a famous quote:

"The harder I work, the luckier I get" by Samuel Goldwyn (or Gary Player!).

You often hear of people coming out of an exam, complaining about being asked 'xyz'. There are also people who when dissecting the exam, reveal some extraordinary questions asked, but having answered them without breaking a sweat: "Amazing, I read it just two days ago!"

The moral of this story (and one of the best pieces of advice given to me this week) is: keep reading and reading right to the bitter end. A random topic may come up for you!

Another phrase which keeps repeating itself is: "You already have the knowledge to pass this section" How many people have said that to you? Really irritating isn't it when you have forgotten the Alveolar Gas Equation for the fifth time!? A large proportion of your answer is structure. The temptation when answering a question that you know something about, is to spew forth everything at once. Another piece of excellent advice I was given, is to imagine that the structure of your answer is analogous to a tree. Do not aim for the fruit immediately - start with the trunk (or definition) and a few main branches thereafter (classify). The examiner will guide you towards which piece of fruit to pick and digest upon!!

E.g. Propofol is an anaesthetic agent which is used for induction of anaesthesia, causing a drop in blood pressure and decreased pharyngeal reflexes.......etc.


Propofol is an intravenous agent used for induction and maintenance of anaesthesia, sedation in ICU, and for the control of status epilepticus. It's chemical name is........

Exaggerated example I know, but it illustrates the point.

This week is all about keeping the mental attitude and trying to stay sane - to pass this exam, you do not need to know every little detail. You need to be strong and structured on the basics, and you need to be clinically safe: when asked during a clinical scenario, say what YOU would do because it's probably what you do most days without thinking.

Saturday, June 7, 2008

Annual Leave

I have one more shift on ICU between now and the D-day of Monday 23rd June. My now familiar hotel booking at the Park Inn Hotel (see previous posting for link) in Russell Square has been made!

I've deliberately combined post-nights time-off, study leave, and annual leave to give me this block of flexibility. My plans are to try and keep to a routine of some catch-up reading in the mornings, travel to the hospital at lunchtime and hunt down consultants/SRs for viva practice followed by our formal viva practice for 90 minutes in the early evening.

More tips:
-No wild gesticulations - hands clasped under the table - don't fiddle with the pencil.
-Don't dig a hole - if you don't know, say so.
-Don't mention something you can't talk about.
-Don't say: "You would intubate....etc" It apparantly annoys examiners -they will not be doing anything apart from marking. Say: "I would intubate..." or "The patient requires intubation"
-Don't use abbreviations or colloquialisms. You need to sound professional.
-Be able to draw all line diagrams from the A to Z.