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I completed my medical school and background EM training from India (Christian Medical College, Vellore and Apollo Hospitals, Hyderabad) where I worked for 4 years. Following this, I devoted (with all my heart) about 1.5 years to do US Medical Licensing Exams. My stint towards an EM Residency in States did not work but it took me to places and it has been quite a journey. I then relocated to London, England to work as a Registrar (Non-Trainee) in A&E. This gave me an opportunity to better understand NHS, EM training pathways and more importantly the EM Mindsets in the United Kingdom. 

Currently, I am pursuing Higher Specialist Training in Emergency Medicine at South East Scotland Deanery where I have the honour and privilege of training under some of the most innovative brains in the field of Emergency Medicine. Over the past few years, I have realised that LEARNING and UNLEARNING (which can be challenging!) is equally important to deliver cutting edge care to our patients.And through this blog, I aspire to disseminate knowledge, assist trainees with exams and stay up to date with contemporary EM literature. I have always been an avid FOAMed supporter because FOAMed has always played an indispensable role during my training. 

Lakshay Chanana
ST4 EM Trainee 
Edinburgh, Scotland

Monday, August 8, 2016

MRCEM part B: 9 unsolicited advices!

Not many of us manage to clear MRCEM part B in the very first attempt. But there’s always (almost) a second time! I’m just trying to enumerate few points here so that it would help the future exam takers pass the exam in the debutant attempt. Most of these points are directly or indirectly discussed in detail by Lakshay in his post http://emdidactic.blogspot.in/2015/09/mrcem-part-b-do-you-know-exam-well.html . This might just be an attempt to rephrase the same as a practice for IELTS writing :-P

1.     When to start studying? How many times should I revise?
Decide what are you – Superman? Batman? Wonder woman?  Shaktiman ? or ACP Pradyumn?
The first 3 might just need 4-6 months of dedicated study, the 4th might need slightly more and the last one…hmm…OK! Decide it for yourself!


2.     OHEM Vs Victoria Stacey!
There haven’t been any randomized controlled trials to conclusively say that one is better than the other. But our team has evaluated multiple case reports with varied results. On initial eyeballing, our impression is that OHEM > Stacey (though you need to study both).  More studies are warranted for conclusive evidence on the same!


3.     “OHEM? That book of Lilliput’s?”
Yes! Read it and understand it LINE BY LINE! Just reading OHEM without adequate clinical experience won’t help but reading this amazing (Often boring) mini, one-stop-for-all book definitely gives you an idea of how to write the answers in exam! Believe it or not it just LOOKS small!


4.     Discuss – Read – Discuss – Repeat!
That’s completely normal for an ER physician, I mean having ADHD! That’s one of our core characters! But when it comes to studying, that might be a problem! So…finding a study partner would definitely help. A partner whose ADHD score is slightly lesser than that of yours would be a good idea. You need to discuss emergency medicine; not game of thrones, cricket, music, travel, poetry….OMG! It’s exam time and everything in the world apart from books look so damn interesting!!!


5.     Solve as many questions as possible!
Online question banks can be subscribed for few months - keep solving these questions. This helps a lot especially when continuous reading becomes notoriously directionless.
These are also confidence boosters.


6.     Mock the exams! Do not let the exams mock you!
So if you are working in a department where there are seniors, registrars and consultants request them to conduct topic wise, weekly, mock tests – Make a plan and cover every topic.
+ 3-4 mega tests a month before the exam will be of great help.
Score your papers amongst yourselves and discuss the answers – Preferably under the guidance of someone who has already cleared the exam.  Let there be some competitive spirit as well!


7.     List those must know criteria, scores, scale, rules - rule them all!

8.     Know what/how *EXACTLY* to write the answers

Select your standard answers before the exam.  Example: Analgesia - Remember 1 opioid and 1 NSAID with dose + route and write that in exam. Don’t waste time deciding between Ketorolac, Diclofenac, Ibuprofen, Paracetamol, etc. inside the exam hall.  Have ‘standard answers’ for ‘standard questions’ to be above the standards in exam!
Be very very specific in all your answers - ’Oxygen’ is not an answer; ‘Oxygen XYZ liters/min via ABC mask to maintain saturation of PQR’ is the answer! (You can fine tune these skills during the mock test sessions)


9.     Let your brain be a tropical iceberg during the exam!

Cool, calm, like a shift in the ED– and you are almost half way through the exam.  Don’t let the global warming effect you during those two hours!
Also, TIME IS EVERYTHING! Do not waste time on a question you don’t know anything about! Move on. Dermatology can wait! Deal with the other emergencies first and come back to the rash in the end for a detailed analysis!!! Be Dhoni! FINISH IT!


Dr. Apoorva Chandra, MRCEM
Twitter: @apoorvamagic  

Resident, Emergency Medicine         
Apollo Health City, Hyderabad                                                         


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