Mount FRCS

The looming FRCS exam was one of the scariest obstacles when I was considering my place in medicine. Was is it worth putting myself through it? However would I manage it when I could barely remember the chapter title let alone the fine details. Was it worth putting my family through that?

Now I am smugly sitting on the other side, yes it was. Also I managed to have a good time with my kids, I ignored my male colleagues who ‘helpfully’ informed me they saw their kids for 30 minutes a week during FRCS prep – I was not prepared to do that and it is not necessary!

Anyhoo, hear is how I survived . . .

First the study strategy.

The best advice I was given was:

1) Read Miller (or your summary book of choice) from cover to cover in a week (I think it took me 10 days). – this is so you know get an idea of what you don’t know, not to learn anything!

2) Study what you DON’T like first. This is so that when you are tired of the books you have what you like and understand already to revise (a wise consultant once told a colleague of mine – ‘It is only revision if you have learnt it before!’).

By the way the worst advice is – ‘read 10 pages of Miller every day from the start of your training’. Miller is so dense that I found 10 pages practically impossible at the height of exam study. If you are early on (and keen) try for 1 page most working days – you’ll have still read the whole thing twice over by the time it comes to start studying!

Part 1 and part 2 are different beasts. Part 1 you need all the annoying details, BUT the answers are written there for you – so work on understanding the principle and only knowing the name of the gene or obscure syndrome well enough that you will recognise it written down! Part 2 you already have the knowledge. Now you need to tell the story – structuring the verbal response is the key here and this needs a LOT of practice! Also while evidence based practice is essential I not disputing that, but remember in the exam knowing the paper lifts you from a 7 to an 8!

So for part 1 I dedicated 2 weeks per chapter in Miller. During this time I re-read each paragraph but aimed to understand it and read around it using orthobullets mainly. I did NOT use papers as it confuses the situation. I made flash cards of the details to remember – if you are lucky to be reading this early in your training start now! Everyday I would review the flash cards I wrote the day before and also on that day last week. So each card automatically got 3 viewings – say I wrote it on Monday, I would then revise it on Tuesday and the following Monday.

If you are struggling to get into studying, or you have enough time before you exam, try writing just 3 cards a day – 1) Anatomy 2) Basic science 3) Pathology BUT concentrate on one small aspect – one muscle, one concept in basic science or just the aetiology of a disease. In fact I would strongly encourage you to do this with anatomy and basic science regardless of if your exam is close just spread these chapters out alongside the others. I found it much easier to remember muscle insertions when I studied them one at a time rather than trying to do a compartment all together. I even split my week lower limb one day, upper limb another, axial, vessels and nerves.

The final four weeks before the exam I dedicated to practice questions and reviewing my cards. Anything I found I didn’t know or understand I would look at more closely again, but it wasn’t that much by that point.

Part 2 I wrote myself mind maps for each disease or concept, like some kind of crazy person these were taped to my bedroom wall. I would go along the wall – look at each map, turn around and try and talk out loud about everything on it. As I went along I would add new things from the evidence or discussion with consultants etc in different colours.

So the evidence this is the icing on the cake. You will not fail if you don’t know the name of the paper but understand the concepts and demonstrate understanding. I really learnt the evidence for a few high tailed topics and was delighted when one of these came up, BUT by the time we had covered the questions I did not have time to talk much about the literature. I think I managed to drop one or two mentions of papers in as I was talking through my answers – I hope anyway its all a blur now!

The myself and a post FRCS friend met every night and during breaks at work and PRACTICED til I was blue in the face. Every list and every clinic I asked to be grilled.

Second finding the time!

So I tried to have 10-15 hours to study a week. I did this with 1.5 hours a night after the kids bedtime and 3 hours each day at the weekend. Also squeeze every drop out of the day – if you can go to work half an hour early to study (before work is never quality family time in our house), read your flash cards or question books between cases (or in the car on a family trip if someone else can drive), check orthobullets when waiting to discuss something with the boss, listen to pod casts on your commute or taking the baby for a walk (Miller but also from the Journals will give you an overview of some of the current papers), orthobullets questions while breastfeeding, make play dates with colleagues and get grilled while they play!

Although I am definitely a night owl I prioritised sleep over more revision time as it is essential to retaining what you have learnt (for more information on this read Why We Sleep by Matthew Walker).

Finally motivation!

Telll yourself you are going to 10 practice questions and that is it – then you can stop. Once you are at your desk you will keep going, it is getting their in the first place that is the barrier – well it was for me anyway.

The most galling bit was, after all the hours of work done, money spent and numerous guilt trips, the note that arrived to tell me that the pin was currently out of stock! I now know that everyone gets this note, but I felt so aggrieved that despite all the toil it represented – they couldn’t be bothered ordering the pin. I REALLY wanted to wear that to ARCP 🤬, I mean when else will I wear it?