When do I start to study? Start 1 year out from the Written Examinations. This will mean that you are studying for 1.5 years overall. In case you hadn’t noticed, this is a long time. This is an endurance event. It is taxing not only on yourself (mentally and physically) but on loved ones around you.
What shall I do before I start studying? Don’t “gently study” before your starting date – give yourself a complete rest from academic stress for at least the 6 months leading up to your start date. In the month before you start studying get your books together – the syllabus is found here. Enjoy yourself buying nice furniture for a study. Sort out a study group. Ideally this should be 4 people. You don’t have to know each other amazingly well beforehand, but clearly it helps if you get on! Your study group is really what gets your through this ordeal – when you feel low or unmotivated, generally there is another who is doing OK and they drag you through. You are then there to drag them through when they are low. It sounds very dramatic and emotional, but that is the honest truth.
What job should I do while I’m studying? Try to organise your training time so that you can sit the exam from ED. People said this to me and I didn’t see why on earth this would matter – but it does. I ended up sitting the exam from PICU which was quite simply a nightmare. It’s much harder to get study leave and the rosters are more gruelling. More importantly, during preparation for the Clinicals you are missing out on vital opportunities to practice while at work. Seriously, do the exam from ED.
Which books should I use? If you’re a NZ trainee, buy all the books on the syllabus. Why not? They’re free after all. Dunn is your bread and butter. Everything revolves around Dunn. Cameron (adult and paediatric) is essential – it is pretty simple and doesn’t seem all that useful, but a lot of the MCQ questions come from Cameron. TinTin is massive, but I found it useful. You should be aiming to read Dunn, Cameron and TinTin on all topics. The Tox Book is wonderful – this is very important for toxicology and envenomations. The other books are less important – I didn’t even open Rosen or Oh.
Which other resources are useful? Life in the Fast Lane is wonderful, you may as well put a bookmark on your browser for this site. ECG Wave-Maven from Harvard University has an enormous ECG database that is perfect for ECG practice. There are many other websites out there, but those are the only two I used on a regular basis.
Should I do a Part Two Course? I attended the Fellowship Course run by Resus.com.au in Aussie early in my study. It was useful to get an idea about what I needed to be doing, and helped scare me into more study – but, in case you were hoping, in no way is a course going to be a substitute for a year of good, dedicated study. I wasn’t able to attend Lou Finnel’s course at Middlemore, but I wish I could have as I know that other people found it incredibly useful.
How do I prepare for the Writtens? Follow the Auckland syllabus. Hopefully you will be able to do each topic 2.5 times if you start studying a year out. Start off aiming to read Dunn, Cameron and TinTin on the Topic of the Week the first time around. The second time round you will have laid the foundations of knowledge, and be able to layer it up from any resource you choose.
MCQ’s Do them, lots of them. You will be scoring a maximum of 60% initially – maybe even more like 40%. The only way to get it is to keep doing them though. I noted common statistics found in MCQ’s in my fact sheets – there are a few facts that are a common theme. A good website for MCQ practice is imeducate – although the questions do start to recur and seem a lot easier than the actual ACEM MCQ’s are.
SAQ’s Have key points at the beginning. Then follow your proformas (found in Written Examination Resources). Think about what the “consultant issues” are – try to show that you are cut from the right cloth, not just a robot regurgitating the correct answer – although of course you have to regurgitate that too. Start doing them with open book technique, then closed book, then to time. Doing SAQ’s to time is very important – you need to train your hand muscles to endure writing for up to 2 hours solid. Start by doing just one to time, then two in a row, then three… and build up. Use a stopwatch and be firm on yourself. Tell anyone in the house not to disturb you for that time and just keep writing. You find that if you go just one minute over on one question, it throws you off for the rest of the exam. Time management cannot be under-estimated in importance.
VAQ’s The advice for SAQ’s can be applied to VAQ’s. For ABG’s and ECG’s have your proformas and follow them. Approach them in a structured way and then interpret your answer relating it the stem and making your answer clinically relevant. Practice ABG’s and ECG’s to time again and again – the ABG’s especially need drilling so that you can do the calculations and recall the formulae quickly.
How do I prepare for the Clinicals? Start thinking about these before the Writtens – although, to be honest, I found this nearly impossible. After the Writtens, take 1-2 weeks completely off. Do not open a book. You will find yourself virtually incapable anyway as you finally discover how tired and broken your brain is. Then read your Clinical Examination book. Learn your Short Case and Long Case Proformas. Practice on your partner, dog, cat, a pillow. Learn these proformas like you are an actor going to an audition – that’s essentially what you are doing anyway. Finally, hit the wards – you will be spending hours doing this, but after a year of sitting alone in a room studying it actually seems quite social. Trawl in twos, threes at the most – otherwise you just find you are spending a lot of time watching other people doing the examinations. Make dates with consultants – it’s far more useful to go with a consultant than it is without as it recreates the impression that you are being examined and gets you used to being watched. Attend the mocks – they are very good at recreating the exam conditions. For the SCE’s you must retain your Written knowledge. It is incredibly hard to bring yourself to study again, but in the final few weeks you do have to get out those old notes and remember the theoretical stuff. Practice SCE’s and be prepared to look like an idiot and have your friends critique you. Finally, set up mock Shorts and Long Cases with friendly consultants. It’s gruelling work, but you have to do it.
Any final comments? In the end: it is just an exam. There are more important things in the world. It is a hurdle that needs to be jumped – but while running the race, remember that you have to be kind to yourself to stay strong. Take rest days without guilt. Make time for your loved ones, and appreciate that this is a hard year for them as well as they essentially become involuntarily “single”. It is hard work, but this exam is fair and passable – and well worth it in the end. It will hopefully be the final exam of your life – it is the top of Mount Career. And the view is going to be great! 🙂