FRCEM SAQ INTERMEDIATE – 1 WEEK to GO – THE DO’s and DON’Ts

Yes, the exam is back. And it shall be over sooner than you can imagine. Well one thing is common for most of students – the Uncertainty. No matter how well they have read.  Also if someone would question them about their preparation at this juncture they will hate you for simply asking.

In January, 2017 I had written a post on my experience with FRCEM SAQ intermediate exam. Of late, I have been getting multiple mails and phone calls from exam going candidates asking how to prepare, what to read and so all. Yes, I may have cleared this exam almost a year ago but totally empathize with all the following statements – “My mind has gone numb” “I keep forgetting everything” “How will I revise” and so on…

One week to go. Maybe you’re the guy who has read and revised the entire course OR maybe you’re the one who is starting today. Either way all any candidate wants is to pass this exam. This is the crash zone. Either you make it or break it. Any panic, anxiety or worries are detrimental. The main reason of this is thinking about the exam result and what catastrophe would beckon if you were to fail! All these thoughts will make you anxious and if with that thought process you try to study you will feel frustrated because ‘nothing is going inside your head!’ and your mind wants to take a break to relax. This loop of worry, anxiety and breaks continue and the day gets over. Similarly more days go by and when it is just 24hours before the exam, you realize YOU COULD HAVE prepared a lot better IF ONLY YOU HAD A WEEK!

So, now, you do have AN ENTIRE WEEK! That’s a whole lot of time if you plan correctly and simply focus on the task to complete in the NEXT ONE HOUR!

Let’s change our mindset from what will happen to what is to be done. Let’s begin. Here is an Eight pointer for you:

1.     Make a promise to yourself now – That you will not think of the result of the exam. Passing or failing is not in your control. Your result entirely depends on WHAT YOU DO NOW RATHER WHAT YOU WISH should happen.

2.     PLAN. IF PLAN fails – REPLAN. Exam preparation in last week is like a busy shift in the ED, your plans of treatment and disposition may work sometimes and most of the times they won’t. You don’t leave your shift because it got crazy. You complete the shift, tackle everything, come what may.  Therefore if you slack in your plan, don’t worry, replan your day from that moment and start doing. Remember every second you waste in worrying makes your brain tired and less receptive to newer information.

3.     Adjust your shifts. Take leaves if possible. Can’t elaborate on that further.

4.     Take a brand new notepad/folder - Name it - ‘LAST MOMENT FOLDER’. You may add your old notes but I insist you write all new . (For that matter I even brought a new OHEM as my old one was all colored and gave me a false impression that I have read everything). The new notes/ folder will be based on your current status where you know what your strengths and weakness are. So make a folder and keep adding nuggets of information to it. Let it be a live tracker of your week and store all important stuff out of whatever you read. It doesn’t have to be bulky or comprehensive. The aim is to identify the key points that that you would want to revise on last day if you had only 2-3 hours left. Keep it 24x7 with you.  So here are few suggestions for the ‘Last moment folder’ - (Filter the items according to your requirements)

a.     Management of every acute or emergency condition (in no more than 3-4points - This helps in answering in exam also) - Write the interventions. Write the Drugs with name - dose - route. (Believe me! This is where most people falter)

b.     Formula/ Calculations like Anion Gap, Sodium correction, Calcium correction, A-a gradient etc with their normal values

c.     ECG changes in various conditions

d.     Classification and scores

e.     Definitions

f.      Pediatric doses and NICE guidelines on pediatric traffic light system

g.     Conditions/ signs with specific names

5.  Use GOOGLE images search- Since most of the questions in the exam are image based, it is suggested that with every condition you read, keep searching it’s images. The first page of Google image search will give you the most representational pictures and it is highly possible that you get one of those images in the exam. Also it helps developing a visual memory that stays longer.            

6. Now the question comes – HOW TO PLAN? Well there is no ideal way. Every person have their own methods. Considering the exam day as day 7. Let us divide the 6 days in hand into 3 segments - a) 72hrs - Days 1-3  b) 48 hrs - Days 4,5 c) 24 hrs - Day 6. Define your goals for each aforesaid segments. Next,  I’d suggest divide these segments into 6 hour intervals. Have a specific target for each 6 hours. Plan your breaks and naps accordingly. This will keep you focused. So if the exam date is 28^th September - The week starts 22^nd September. 

A) Days 1-3 (22,23,24^th September) - Plan to simply read through entire syllabus according to the topics in the curriculum and identify key points needed for revision. Since it’s the last week I would not go for bigger reference textbooks, rather read from books and sources which I am familiar with and are exam oriented viz. Oxford Handbook of Emergency Medicine and Acute Medicine, Few NICE guidelines, SCORES. Keep 6 hourly targets for example  - Surgical and Environmental emergencies in 6hours. While reading keep marking ‘Q’ whatever you feel is a possible question. (Well sometimes there were more than 20 Qs marked on the page!). None the less, it will help you in later stage.  Also keep writing the points which needed to be revised and add them to your ‘last moment folder’.       

B) Days 4-5 (25,26^th September)- The REVISION - These 48 hours revise the highlighted texts or the ‘Qs’ you have marked in your books. Keep adding and updating your ‘Last moment folder’.  If you have some topics pending (probable) and time left (improbable) then try covering them as well.

C) Day 6 (27^th September)- This is the last day before exam. Plan your day in 2^nd hourly intervals. DO NOT read anything new. Just read you ‘Last minute folder/ notes’ and the topics. You have to ‘by heart’ all important stuff.

D) Day 7 (28^th September)- Day of exam. Preferably do not keep anything to read today. If you still have to, then no more than 1-2 hours with only pre-planned topics from your revision folder. Don’t read new stuff neither do haphazard studying, this will drain you off energy.

 Nobody gets a good sleep before an important exam. So don’t worry about it much. Have a decent breakfast. Keep nuts or chocolates with you when going for exam (although you’ll be provided refreshments). Stay hydrated but pee before the exam. For further details of the way exam is conducted and how to manage your time, kindly refer to my previous post in January.

7. Online questions - Use them to test yourself - Assess your time management. Use these questions to streamline your answers.

8. Breaks and naps - Take effective breaks of no more than 2hours per 6hour. Do not be away from reading for more than 12hours. The break should recharge you and not leave you with guilt. 

Dear Friends, in the last week, the objective is to cover entire syllabus and revise it effectively. There may be different way to prepare for this exam. I just shared with you what I would do if it were 7days to the exam. I wish you the best. Stay Calm, Stay focused.

Let me know if this post helped. Cheers! :)

Written by:

Dr. Akshay Bhargav MBBS, DEM, MRCEM

Akshay is an emergency medicine enthusiast. Originally from Kanpur, he did his graduation from Kasturba Medical College, Manipal and his post graduation residency in Emergency Medicine from Apollo Hospitals, Hyderabad. He Loves teaching via simulation methods. His dream is to spread emergency medicine awareness among masses and improving standards of ED care in the country. As a student has always hated examinations but thankfully chose never to give up.