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How to pass the FRCA
During the training programme,[link widoczny dla zalogowanych], the trainee anaesthesist takes an examination in two parts,[link widoczny dla zalogowanych], the Primary and the Final called the Fellowship of the Royal College of Anaesthetists (FRCA). This exam is set and supervised by the Royal College of Anaesthetists. The standards are high and those doctors who pass can use the letters FRCA after their name, but only those who have completed the training programme successfully and been awarded a certificate to identify this (CSST, a Certificate of Completion of Specialist Training) can have their names included in the Specialist Register held by the General Medical Council (GMC).
Try to make your first attempt at the final exam for fellowship of the Royal College of Anaesthetists (FRCA) your last. When you do decide to sit the exam,[link widoczny dla zalogowanych], allow yourself no distractions and no excuses
Don't try to be perfect. Learn the technique to pass the exam, rather than concentrating on knowing everything to the degree. You must know the basics backwards and be safe
Practise, practise, practise. Reading is important; practice is essential
Buy the Royal College of Anaesthetists' guide to the final FRCA and, more importantly,[link widoczny dla zalogowanych], learn it.
Everyone has their own theories as to how many questions you need to answer to pass the MCQ. Some people answer every stem of every question; others answer only the stems they are certain of or for which they feel they can confidently guess the answer. Ultimately, it doesn't matter which technique you choose as long as you pass. However, with negative marking you need to answer 75% of the stems as an absolute minimum; with practice you will be able to decide which technique suits you.
Whether you complete the answer sheet as you go through the paper, or in one go at the end, you must avoid any mistakes with box marking. This can easily happen, especially if you get out of sequence by, for example, missing out a whole question. Check, check, and check again.
Having a good structure to your answers is crucial. It allows you and, more importantly, the examiner to see that your mind is organised. As with the vivas, most questions can be answered by using similar structured headings, then tailoring the of the answer to suit the specific question asked. Examples of structured headings include:
With practice these headings will become second nature, giving you more time to concentrate on padding the answer,[link widoczny dla zalogowanych], which actually gets most of the marks. They may also trigger your memory for details relevant to the question that you may otherwise have forgotten
The college now gives the percentage weighting of the marks for each part of the question on the paper, allowing you to balance the emphasis of your answer. So brainstorm for a minute or two at the start of the answer,[link widoczny dla zalogowanych], write down the important headings, and then write the answer. Try to start with the most important issues, but do not forget to include the issues that may apply for all similar questions. Remember to include the feely easy points, such as communication with family and nursing staff. Other marks are gained in paediatric questions,[link widoczny dla zalogowanych], where you must include common formulae and drug dosages.
Never write the question at the top of the page. This is simply a waste of valuable time. There are no marks for presentation, but it goes without saying that illegible handwriting or a complete lack of structure to the answer will inevitably make your answer more challenging to mark, and may therefore make the examiner less sympathetic to your plight
To help the examiner pick out the important points,[link widoczny dla zalogowanych], use headings and bullet points and be succinct. Put down as many points as you can in the 13 minutes; you will not lose marks for points that are not in the marking schedule.
At the risk of sounding like a broken record, practise! Practice should ideally begin as soon as the written exam is over, but a complete break for a few days is entirely justified. However,[link widoczny dla zalogowanych], do not wait for the results of the written exam. These are being released later and later, and although it is demoralising to practise only to find you have not been invited for a viva, any practice can only be beneficial for your next attempt
Viva practice is almost universally feared by candidates, who are worried about themselves in front of their colleagues. Remember, everyone who gives you a viva will have been in your shoes and humiliated themselves on more than one occasion. Also, it is far better to humiliate yourself for free at work than to pay for the pleasure during the exam.
Again, try to be as structured as possible when answering viva questions. Ideally, try to start your answer with an outline of the key issues relating to the question, to show the examiner you can put the clinical scenario into context. Structures to practise include the response to any question of the form:
Structures such as this help to ensure you don't miss out important information and also act as triggers if your mind goes blank. For the long clinical case, you will be expected to summarise the case and key issues at the start of the viva. A good way to practise this is to write yourself focused patient summaries when seeing your preoperative patients.
This is important, and again it improves with practice. Sit up straight, smile, and try to look confident. Practise an obligatory pause before starting your answer; this gives you time to think and makes you appear calm. Speak slowly and clearly and try to be precise
If you are unsure of your answer or know that there are several different possible answers, there is a natural tendency to use vague conversational adverbs such as maybe do. or probably do. Try to avoid this as it simply undermines any correct answer you give. If you know there are a number of different approaches to a problem, say so. Then follow with a statement such as,[link widoczny dla zalogowanych], the technique I am most familiar with is. or my institution the usual practice is. Remember that you are trying to show the examiner you are knowledgeable and decisive, not vague and non-committal
Use the scrap paper provided to write down key words in the question to keep yourself on target with the answer, and also to keep track of complex problems. Otherwise, it is easy to become entangled in a discussion about minutiae and then forget an important detail for which you would have gained more marks
Finally, if you realise you have made a mistake acknowledge it immediately and correct yourself, perhaps by asking the examiner if you can rephrase your answer or even, if it is early in the question, start again. This is far better than nervously trying to pretend the mistake never happened or, worse still, trying to convince the examiner you were right all along.
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