That Three Day ‘Quiz’ Introduction to the FRCPC Exam Ian Rigby
Outline • Exam Experience • Written Exam Format • Preparedness • Define What You Need To Know • Timeline to Success • Successful Studying Tips • When It Is All Said and Done
Exam Experience • Registration due by Feb 1, 2008 • Exam: May 20-22, 2008 • It is held in Ottawa at the Royal College of Physicians and Surgeons building (downtown Ottawa)
Exam Experience • First two days are the written exam • Starts at 0900 each morning • 3 hours in length • Dress is casual • Third day is the oral exam • Can be in the morning or afternoon • Dress is business/professional
Written Format • 20-25 questions per day (1 booklet/question) • Usually 3 -5 parts to a question • “Questions will cover the depth and breadth of Emergency Medicine including relevant anatomy, patho-physiology, pharmacology, clinical management, systems administration, recent literature and research methodology .” • These are short answer. A word or phrase or at most a couple of sentences. • Has been written this way to help eliminate the ambiguity of the questions and exam.
Old School Format… • 55 year old male presents to your ED with CP and the following EKG: • Outline your diagnostic and treatment options and how you would manage this patient.
Current Format • 55 year old male presents to your ED with chest pain. His PHx is HTN. He is on no medications and has no allergies. His EKG is as follows:
Example Written Question • (1) What cardiac vascular territory is involved in this patient?:___________________________________ • (2) What is the most commonly affected coronary artery that gives this EKG picture? ___________________________________ • (3) List 5 treatments that could decrease this patients mortality: • (a) • (b) • (c) • (d) • (e)
Written Format • One big hint … make sure to turn over all the pages of the written exam • Some questions continue on the backside. So flip through all of your exam booklets.
Preparedness • Goal of the exam is to test competency
Preparedness • But this is ‘competency’ as a consultant in emergency medicine
Define What You Need to Know • I: Critical Management Principles • Airway • 2. Mechanical Ventilation and Noninvasive Ventilatory Support • 3. Monitoring the Emergency Patient • 4. Shock • 5. Blood and Blood Components • etc
Define What You Need to Know • Examiners develop their questions using common information sources that we all use • Texts: Rosen’s Emergency Medicine, Tintanelli’s Study Guide • Review Articles: Emergency Medicine Reports or Emerg Med Clinics of North America. • Hot topics in the public eye: Overcrowding, Sepsis, etc. • So use these resources in your studying
Rosen’s Limitation • Dermatology • Pediatric Presentations • Pediatric elbow • UTI • Limping child • Admin and Research
Admin and Research • Many of the examiners are academic EM docs involved in other aspects of EM (Administration, EBM, etc). • Many of these issues are discussed in forums such as CJEM or put into CAEP position statements and protocols • Look at these for ideas of hot topics
What Don’t You Need to Know? • A new study is published in NEJM Jan 2008. A RCT of miraclarone vs. placebo. • This wonder drug converts VF to NSR 100% of the time, safely sedates intoxicated head injured patients, restores night shift deranged circadian rhythms and treats male pattern baldness. • Also had an underpowered trend towards making people win the 649 lottery • Will this study be on your exam?
Question Development Topic Areas Generated (Wide variety of topics) Questions and Answers Developed/Refined Incorporation of question into the examination Trialing of Question/Answer Performance
What Don’t You Need to Know? • How well should you know drug dosing? • Know: • Resuscitation drugs • Drugs used in time dependent situations • Commonly used drugs
What Don’t You Need to Know? • Finally, if you’re unsure if you need to know this or not, ask yourself if one of your preceptors would know this.
Successful Studying Tips • Incorporate review time while making your notes • By the time you get half way through Rosen’s you’ll forget what you’d made notes on. • So prior to your reading/note taking session spend half an hour reviewing some of your previous notes.
Successful Studying Tips • Anticipate the Exam Questions • After each chapter you read or article you review, list the 3-5 most likely examination questions that could come from this. • Is a good review for later in your studying. (Review Q’s, flashcards, etc.) • Predicted >50% of my FRCP exam questions this way
Successful Studying Tips • It’s late, I’m short on time and need to develop a good question with a standardized answer…. Tables are worth their weight in gold for exam questions!
Think Like A Herd Of Examiners • Questions are unlikely to be on contentious areas of medicine. • i.e. What is the best drug for converting afib? • Less likely to ask about trivia • i.e. What is the correct pediatric dosing of ilbutilide if using it for tet spells in a 6kg child? • Should know drug doses for resuscitation and commonly used drugs, though • DON’T STUDY MINUTIA • Recall this Process: Questions and answer key developed Review of question by Committee and evaluations
Successful Study Tips • Don’t spend time making detailed notes on areas you already know well • Your notes are not meant to be a complete text of emergency medicine, but a study tool for areas you don’t know well.
I Don’t Know This! • Everyone will run into questions they only know partial answers or don’t know at all. • Spend a couple of minutes before the exam figuring out how you’ll handle the ‘I don’t know question’. • Don’t mess up the next set of questions by stewing on the one you missed!
After It’s All Said and Done... • Your marks from the written and the orals are reviewed by the exam committee • Your identity is blinded to the committee • Pass/Fail decision is made on the composite score of the written (50%) and orals (50%) • Thus, you can fail one part and still pass the exam
After It’s All Said and Done... • Approximately 1 - 2 days after the exam, you log onto the Royal College Website and receive a letter as to whether you’ve passed or failed the examination. • Website: rcpsc.medical.org
After It’s All Said and Done... • Almost everyone will pass! • If the news is bad….. • You will receive a formal evaluation from the Royal College about your areas of deficiency. • This is general in nature. • The results of your examination can be appealed. But this is a difficult option.
Appeals • The Royal College will hear appeals about your examination on the basis of an unfair examination process • Extreme circumstances (i.e. you go into labour part way through your orals) are handled on an individual basis. • You cannot appeal the exam results based on the content of the questions • (i.e. Question #5 was stupid because…..) • Review the process of appeals in your candidate’s guidelines by the RCPSC
After It’s All Said and Done... • Remember that most everyone will pass • So don’t get too worried about the “Little Three Day Quiz”