How To Pass the FFAEM Examination

1. How To Pass the FFAEM Examination

2. FFAEMoutline Why an exam? How to apply Present format Preparation On the day Components Tips Marking Outcome Possible changes

3. Assess knowledge, skills & attitudes Assess effectiveness of training programme Required for CCST Clear and defensible marking FAEM responsible for training standards FFAEM exam twice yearly May/Nov Why the FFAEM?

4. Other requirements for CCST Satisfactory completion of 5 years training Testimonial from Programme Director or STC Chairman Including all essential secondments

5. How to apply Contact Edinburgh! for an application Satisfactory 4th year assessment Two clinical topic reviews (3 copies) Training record (3 copies) Full curriculum vitae (1 copy) �680 cheque Two photographs (Any other information, eg: RITA copy) Submit at least 8 weeks in advance

6. Format Read, abstract and appraise paper 1hr Critical appraisal viva �hr OSCE 1hr Clinical topic review viva �hr Management viva �hr

7. Preparation Regional teaching Prepare topic reviews Keep training record (disk version) Critical appraisal texts ? course Practise in structured journal clubs Management topic texts ? ! Management course (clinical revision)

8. On the day (November 1998) London, Royal College of Surgeons 29 candidates over 2 days 3 groups of 4 or 5 each day 12 examiners - 6 encountered Briefing meeting @ 08:30 Staggered timetable inc. lunch, tea/coffee Adjudication @ 17:30

9. Critical appraisal Likely RCT, diag. test or syst. review Read paper & construct abstract (? � hr) Checklist appraisal (? � hr) Viva (half hour) �Tell me what the paper was about.� �Tell me how you would improve it.� �What errors? Were results significant?� �Is it relevant? And should I read it?�

10. Critical appraisal tips Structured abstract introduction, method, results, conclusions Appraisal (use a memorable checklist) comment on: clear aim, clear presentation, complete literature search, robust methodology, validity of results based on method, correct conclusions based on results

11. OSCE 12 stations - 5 minutes each Clinical scenarios � Procedures X-ray spotters � Pharmacology Patient photographs � Data interpretation ECG�s � Interactive stations (or combinations of the above)

12. Clinical topic vivas �Give me an outline.� - key points Methodology of each literature search Details of results Justify conclusions & opinions References queried Know more than the examiner Choice of topic cannot be criticised (Training record - only a few minutes)

13. Clinical topic tips Start very early with clinical topic reviews i.e. first year of SpR training Needs to be in 2 months before exam Keep subject focussed (<30 references) In depth, balanced & up to date Read all quoted references Keep it interesting, avoid politics Check by trainer before submission

14. Management One written scenario �hr In-tray (10 components) �hr General discussion �hr Testing: analytical skills, time management, communication , lateral thinking, team building, prioritisation, medico-legalities, handling media, ethics, confidentiality, role of consultant etc

15. Management tips Active involvement in management of own department with trainer e.g. Complaints, media, law, guidelines, risk Discipline, misconduct, performance Standards, quality assurance, training Budgeting, equipment, business case Recruitment, staffing, core service Consent, competence, registration Government, governance, PCG, HAZetc�

16. Marking scheme 8 - Exceptional performance 7 - Significantly better than a pass 6 - Clear pass 5 - Fail but possibly negotiable 4 - Fail 3 - Total exam fail Cumulative average pass rate 86%

17. Unsuccessful One mark of 3 Two marks of 4 Total mark less than 24 NB: Majority fail only one part, 7 in topic reviews can compensate for a borderline 5 elsewhere

18. After (5:30pm) Adjudication for between 10 and 60 min First group finish 2 hours before last Worrying about OSCE�s in the pub Announced by individual envelopes Bubbly (not sherry) for success

19. Feedback Immediate for those who fail - (general impression, not actual marks) Later detailed critique - Chairman�s letter to candidate and trainer, not actual marks Counseling is up to the local trainer Retakes do one additional topic review Concerns regarding training scheme to trainer only

20. Reading Critical appraisal texts: Crombie - Pocket Guide�����. Greenhalgh - How to read a paper�.... Sackett - Clinical Epidemiology�.. Riegelman - Studying a study��.�.. Pastest - Statistics for exams��.. Cambridge reference text (or others) Yearbook of Emergency Medicine

21. Structured journal clubs Academic E. M. A&E Nursing American J. of E. M. Annals of E. M. Arch. of Dis. of Child. B.M.J. Emergency Medicine Emergency Nurse European J. of E. M. Injury Injury Prevention Journal of A&E M. Journal of E. Nursing Journal of Trauma Lancet New England J. of M. Pre. Hosp. Im. Care Resuscitation

22. Summary Examiners searching but pleasant Taken very seriously Exam fair but stressful Different and unknown Clinical questions difficult Management viva long

23. Evolution? Portfolio instead of logbook ? Single larger topic review ? More interactive OSCE stations ? Airway skills station ? More formal 4th year assessment ? e.g. OSLER / TOTO structured format observing clinical practice in normal place of work (Cons. + SpR ? external assessor)