RickInOz

… here’s some more detail about our ordeal this last week and how we got there.

Firstly, not everyone gets to take this exam. It requires at least 2 years of advanced ICU training, and a considerable amount of revision. As I wrote in previous posts, my approach was the “tortoise”. So, rather than worrying about having to cram close to the exam date, I revised little and often from as long ago as last October.

Then, the application process is quite laborious and required a sign-off from the consultant responsible for training and education at the RAH.

Having been accepted for the exam, we all pitched up to the written section over 2 months ago. After a tense wait for 2 weeks fortunately the result was positive and meant an invitation to attend the clinical trials.

The clinical exams are held in the major Antipodean state capitals on a rotating basis. This time it was Sydney so, after being given the nod, I booked flights and a hotel. To avoid an early start or any rushing on the first day, we all arrived in Sydney the day before and tried as much as possible to relax. Fortunately my hotel room had a sea view, and I whittled the afternoon away with a little light polishing revision and slobbing out.

The exam is held over 2 days with Clinical Cases on the first day, followed by Vivas the next. The idea being to replicate actual working practice and hence the clinical section involves real ICU patients actively undergoing treatment.

The clinical case takes a simple format. We get 10 minutes to assess the patient and ask questions about their current status, then the examiners have 10 minutes to ask us questions about the patient. The objective is to rapidly assimilate information about their current state, perform a clinical examination and then formulate both a concept of the key issues and a sensible management plan. This is easier said than done and it is a tough ask to expect someone to work out exactly what is going on in 10 minutes, summarise it succinctly and, most importantly, cope with the inevitable nerves. All of this repeated twice.

Truth be told, I didn’t think I’d really done myself justice in the first case and, although the second one went well, worried that I’d thrown the exam at that stage. This meant strangely that I was actually feeling quite relaxed going into the Vivas as, convinced of failure, I was determined just to use them as a rehearsal for next time.

The vivas also last only 10 minutes each. Most of them are just a simple Q&A session with an examiner, but there was a radiology station, a procedure station and a communication station. The latter was a designed to test the candidate’s ability to perform as a consultant. The scenario we were given was of a registrar who has inadvertently caused the death of a patient. I was impressed by how well the actor portrayed a distressed junior doctor, and it was easy to get immersed in the role-play.

Then we had to wait. This was and still is the most memorable aspect of the whole process …. the endless waiting. I barely slept the night before the clinical cases, then there was a lengthy wait before I got to do each case, and then before we were released. That afternoon seemed to drag on forever and heralded another sleepless night. Worst though was the wait between finishing the examination itelf and getting the results. We went for lunch and a beer, but no-one had much of an appetite. With hours to spare we ended up going and sitting on the beach while making stilted small-talk.

Obviously it was all worth it in the end, but I am in no hurry to go through this again. Hopefully it will be the last post-graduate exam of this format that I will ever have to go through. And most importantly, we can now get on with our lives and start planning all the holidays, activities and purchases that we have been deferring for so long. Onwards …..