Specialty exams are a big deal. They are often the first time that trainees face potential failure which, in turn, can lead to significant mental health problems. When I was preparing for my FRACP exams in paediatrics, I felt like a huge beast was slowly approaching to finally reveal me as a fraud. I found that the culture around me fed into these fears – I believed that this would be the hardest thing I’d ever done, that I would have to sacrifice all my time with friends and family and that this would be one of the worst years of my life. I found my fellow candidates and I rarely spoke about the positives of studying for specialty exams.
Like a teenage patient with a needle phobia, if you approach a situation with fear you are more likely to have a painful experience. On the other hand, if you can approach the exam in a calm state of mind you might find that there is very little pain and so much to gain from preparing for your exam.
I would like junior and senior medical officers to talk about specialty exams with more positivity and enthusiasm; to do so I want to bust four myths about sitting specialty exams.
I know this myth to be false mostly because some of the greatest doctors I know have failed their written and or clinical exams, but also because it is impossible to predict in advance the candidates that will pass or fail based on their day-toy-day performance.
In reality, it is not the final mark but the process of studying for the exam that makes you a better doctor. I spent a lot of my early years as a registrar making educated guesses and surprising myself when I found I was right. I was constantly looking things up on the run and writing things down to look up later but never quite finding the time. I was terrified of a senior critiquing my clinical skills because I always felt like I was doing just enough to get by.
Preparing for specialty exams is a time when you have the opportunity to read more about a specific topic that interests you; you start to understand why we do things a certain way and you can then start to say you genuinely know what you are doing. You develop skills and critical thinking that will one day help you to become the doctor you always wanted to be. If you focus on enjoying the journey and think positively about the process of studying, then the final exam will seem less daunting and more achievable.
The exam is a huge time commitment, but good physical and mental health is vital for good performance, and support from friends and family is crucial to help pass the exam. Sacrificing everything you enjoy and isolating yourself from your friends and family can create an incredible amount of pressure and it is the surest way to fail.
The truth is that you have to prioritise everything in your life to pass the exam. The three main traits you need to pass an exam are: (1) intelligence, (2) time commitment and (3) good mental health. In a room full of highly intelligent and very committed trainees, it is often the third trait that is the biggest determinant of the final mark but conversely, can be the factor that we dedicate the least amount of energy to. You will be surprised to find how much spare time you have just by rearranging your schedule. I suggest, for example, you rank your favourite TV shows. As the year progresses, watch only your favourite three shows, then your favourite two then, prior to the exam, only your favourite. Do the same with every activity and person in your life.
No one can study for 100% of the time; go easy on yourself. And when you are spending time away from study, leave the guilt at home with your notes. In the final week leading up to the exam, looking after your health and your mind is probably more important than additional study, so spend time with the people that make you smile and do that activity that brings you peace.
It is no secret that specialty exams are difficult, they are designed for an intelligent cohort and there will be questions that no one can answer. The important thing is to not be intimidated by the difficult questions, to keep calm and remember that everyone is in the same position. “Don’t let ‘perfect’ get in the way of ‘good”, as the saying goes.
The fact is that this may be the most challenging exam you’ll ever do, but it is important to keep it in perspective. There are greater challenges in life and you will have necessarily sat difficult exams in the past. Recently, I found myself the most senior doctor at a critical resuscitation. For me, those brief minutes waiting for the patient to arrive were a lot worse than the minutes before walking into an exam room, but I used the same calming technique that got me through the exam. A few deep breaths and I was able to focus my thoughts and structure my ideas while a small part of my brain was still panicking. There is a lot of evidence that mindfulness exercises can improve performance. If you practice one regularly as part of your study schedule you will find that no situation is “too hard” to handle.
This is probably the most damaging myth going around because when we talk like this, we set ourselves up for a tough time.
Studying for the exam can be the best year of your life if you look after yourself and approach it with positivity. The knowledge I gained that year has been invaluable to my clinical practice. I developed a deeper understanding of my patients and met mentors that taught me the ‘art’ of medicine. I got to know more of my colleagues and made lifelong friendships with my study group. Most importantly I developed a sense of confidence and learnt to trust myself in decision making.
If you enter into your specialty exam preparation with a positive attitude, good mental health and a sense of perspective then you will beat that beast and prove what everyone knew all along – that you are meant to be here.
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