That Three Day ‘Quiz’

1. That Three Day ‘Quiz’ Introduction to the FRCPC Exam Ian Rigby

2. The Three Day Quiz

3. 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

4. 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)

5. 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

6. 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.

7. 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.

8. 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:

9. 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)

10. 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.

11. Preparedness

12. Preparedness • Goal of the exam is to test competency

13. Preparedness • But this is ‘competency’ as a consultant in emergency medicine

14. 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

15. 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

16. Rosen’s Limitations

17. Rosen’s Limitation • Dermatology • Pediatric Presentations • Pediatric elbow • UTI • Limping child • Admin and Research

18. 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

19. What Don’t You Need to Know?

20. 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?

21. 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

22. 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

23. 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.

24. Successful Studying Tips

25. Timelines for Success

26. Timelines for Success

27. 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.

28. 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

29. 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!

30. 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

31. 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.

32. 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!

33. 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

34. 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

35. 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.

36. 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

37. 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”