When should I start studying?

  • Ideally 12 months out from the written paper, to allow time for the “average” trainee to cover all the material in the syllabus properly without being too rushed
  • The first few weeks of study is likely to be inefficient as you will spend a lot of time procrastinating and “getting organized to study” and feeling overwhelmed. It will take a while to get into an effective study routine
  • If you are starting to study < 12 months out from the written, you have no time for a slow adjustment period, you need to move into high gear ASAP
  • If you need to factor in for family commitments, eg high maintenance partner, young kids etc, you may need to allow for a longer period of study

How much do I need to study?

  • The official College recommendation is 1,000 hrs of study
  • Based on my own experience and from talking to other people, many candidates are successful after having done 500 – 800 hrs of effective study
  • This equates to, minimum, 10 hrs per week of effective study for 1 year. That is a lot of time, on top of your usual 50 hr working week plus family commitments!
  • This is only a guide, everyone is different. You should study as much as is necessary for you to have a good grasp of all the key concepts and to at least rote learn the less important, non-core stuff

How do I study?

  • First look over the syllabus Learning Objectives and the list of past Short Answer Questions to get an idea of what you are expected to cover
  • Write out a study plan that will allow you to cover everything once by 2 months out from the written exam, to allow adequate time for revision. You probably will not retain much knowledge from your first read through and will need time to revise everything again
  • It is probably best to cover all topics once, before you start going back over topics to revise, otherwise you may get stuck redoing one topic over and over and run out of time to cover everything
  • Budget more time for respiratory and cardiovascular physiology as these core topics contain many concepts that you will be expected to know very well
  • To make things easier for yourself when it is time to revise, I strongly recommend that however you study, you end up with a set of flash cards – or equivalent – that succinctly summarises the most important key points of each topic. This way, when it comes time to revise just before the exam, you can quickly refresh your memory by looking at one flash card, rather than re-reading a whole set of notes. This is why it is much better to write your own flash cards than use someone else’s – they are specific to you, and should prompt you to recall the stuff that you tend to forget, not what someone else tends to forget
  • Everyone’s learning style is different. I favour reading around widely, using textbooks and whatever other resources you find useful – making sure that all the relevant Learning Objectives are covered – in conjunction with model SAQ answers and the Examiners’ Reports and writing your own notes, as I believe that the process of reading the material, deciding what is important – being guided by the Examiners’ Reports and model SAQ answers – and discarding the rest, then writing out the key points in a format that is intuitive and natural to your own way of thinking, is what will help you to understand and remember the information. This, obviously, is very labour intensive
  • Another approach is to focus on past SAQ questions and study from past candidates’ study notes and model SAQ answers and not write your own notes or refer to textbooks or the Learning Objectives. The appeal of this approach is that it is much quicker, the work has already been done for you. The potential downside to this approach is that you are more likely to end up with gaps in your knowledge, have a more superficial understanding of key concepts, and if you think in a different manner to whoever wrote the notes/model SAQ answer, it will be much harder for you to understand and remember the information. Plus, if the model answer is poor quality, your answer will also be poor. Having said that, candidates have used this approach and passed
  • You must study in whatever way works best for you. This is a tough exam, not because the concepts are really hard to understand, but because of the sheer scope of what you are expected to know and remember all at once. The expected standard for this exam is much higher than for your university exams. From what I have heard, it is also higher than for the expensive Critical Care Diplomas that a lot of universities seem to be offering nowadays. A superficial, rote learned level of knowledge will not be enough to get you through unless you get lucky
  • I know of a candidate who crammed for 3 months, and passed. I know a candidate that did not study equipment at all because they ran out of time, and passed. I’m sure you also know of, or have heard stories of people who have passed without putting in all the time and effort that tutors and examiners always recommend to you. If you are planning to take shortcuts, just be aware that these are the exceptions, not the rule. The better prepared you are, the less luck you need to rely on
  • It would be worthwhile to watch these interviews by anaesthesiacoffeebreak on YouTube when you are first getting organised to study

How should I not study?

  • Recently a trainee pointed out to me this excellent resource
  • This is a pdf document written by Dr Mark Reeves, former Chair of the Primary Exam subcommittee. It contains fantastic advice and insight into the exam. Based on his experience in remediation interviews with failing trainees, he has compiled a list of advice on what to do if you want to fail the exam
  • If you are about to start studying you must read this document!
  • This comes from an experienced examiner who wants you to pass. Ignore his advice at your own peril

Why do they make this bloody exam so tough? This is bu!!$hit, learning this crap won’t make me a better anaesthetist!

  • We have all been there and thought that. Some things you will learn that will actually help you to be a more astute clinician, such as understanding about alveolar dead space and the ET-arterial pCO2 difference – and hopefully also make anaesthesia more interesting for you. On the flip side, I don’t think memorising the complement cascade or the structure of G protein coupled receptors has ever helped me clinically
  • The value of having the Primary exam is not solely in ensuring that candidates have a high level of knowledge, it also tests whether the candidate
    • has the determination and commitment to pass this obstacle
    • is able to think clearly and perform under stress
  • These are traits that are desirable in an anaesthetist
  • Whether this actually is an effective screening tool or not, is irrelevant. At the end of the day, this is a barrier exam. You must pass it to progress in your training. Therefore, if you wish to become a specialist anaesthetist, you must do whatever is needed to pass it

The Right Mindset

  • “I’m aiming to sit in… I’ll see how I go…”
  • “I’m just gonna sit as a practice run, and if I happen to get through this time then great…”
  • Personally, I believe that the above mindsets are not helpful in maximising your chances of passing, for the following reasons
    • Without a definitive target, you have no incentive to study
    • If you go to the exam underprepared, you are gambling on getting lucky to pass
    • Statistically, your best chance of passing is your first attempt, so if you are using your first attempt as a practice run, be aware that at your next sitting you have less chance of passing than your first
    • $5K+ is an expensive practice run
    • Do you really want to have no life for another 6 months?
    • In the long run, I am certain that there is no correlation between how many times it takes you to pass the Primary and how good an anaesthetist you will be – so don’t let it get you down too much if you are finding it hard to get through – BUT it is very demoralising to fail, so you should avoid doing that!
  • The mindset that I suggest to you is this:

“I have x months until I sit. I don’t want to extend the pain for a further 6 months, therefore I will do whatever is necessary in that time to ensure that I pass!”

  • This way you have a definitive end point, allowing you to plan out your study and gauge whether your progress is on track
  • Everyone has a different learning style, everyone learns at a different rate
  • If you feel that it takes you twice as long as everyone else to learn something, then the solution is simple – study twice as much
  • I know that life tends to interfere with such an over simplistic view, but I really think that having this mindset will help to give you your best shot
  • Do it once and do it right!

Final Thoughts

  • Accept that the next year of your life must be mainly dedicated to studying. Unfortunately, there is little room for life/study balance. It will be painful. But it will end. If you do not commit fully, you will just prolong the pain for another 6 months
  • Studying for this exam puts a huge stress on relationships. Discuss with your partner at the outset about what a big deal this exam is and explain that you need to focus on study. A supportive partner will make things much easier
  • Try to offload all other chores that can be outsourced, so that you can focus on study. Consider hiring a cleaner or nanny, if needed. The cost will be less than the cost of resitting the exam, and money well spent.
life study balance
Life-Study Balance

Wishing you happy – or at least effective – studying!