The ExamNRC 2015

Adam Szulewski BSc, MD, FRCPC, MHPEAssistant ProfessorDepartment of Emergency MedicineQueen’s University

What to expect

• Fifth year• Studying Tips• Written Exam• Oral Exam• Final Thoughts

Fifth year

• Sucks

But…

• You become a better doctor by the end

Fifth year

• Start early• Make a schedule• Schedule weeks off now• Try not to get behind in the readings• Build in time at the end of your schedule for

review

WRITTEN EXAM

• 2 consecutive days; 3 hours each• Usually in a conference room– Public library– Hotel conference room

• Administered like any university-level exam

• Written with other specialties• ~25-28 questions per paper• Each question (or group of

questions) in its own booklet

WRITTEN EXAM

• Question starts with stem describing clinical scenario• Will ask questions relating to stem (3-8 per question):

– What is the most likely diagnosis– What is the next most important step– List 6 causes of this presentation– List 6 therapies that should be initiated immediately– List 4 complications of this problem

• You don’t necessarily need to know the answer to the first question to answer the remaining questions

WRITTEN EXAM

• Usually STRAIGHTFORWARD• Rosen’s Tables and Lists make up the lion’s share• But not exclusively

• They are looking for lists• Answer in a few words – easier to mark• May have visual stimuli• Answers are WEIGHTED as indicated• YOU WILL NOT KNOW EVERYTHING

• Expect to blank on 1-2 questions per paper

ORAL EXAM

• Everyone in Ottawa • Either AM or PM group– Sequestered for ~1-2 hrs before or

after• 6 exam stations and 2 rest

stations• Mass start, rotate around

hallway, bell rings, OSCE-style

ORAL EXAM

• IN THE ROOM:– One examiner– 2 cases per room (6 rooms + 2 rest stations)– 10 min per case (20 min total)– Examiner keeps time – not your job– Examiner will be stone-faced– They want you to pass• “Is there anything else you would do…?”

– Take these life-lines. They are not tricks.

ORAL EXAM

• Question Format:– Clinical stem – describe initial management, diagnostic steps,

DDx, definitive management– May have visual stimuli

• Question Content– Predictable, bread and butter

• Difficult airway – many different scenarios• Trauma resuscitation• Crashing neonate/child• Child abuse• Ethics / CANMEDS / Communication• Procedures

STUDYING TIPS• Talk to your recent grads – it worked for them

• Notes, cue-cards, questions, ppt slides, etc

• Make practice questions• Meet with a partner or group• Rosen’s + Minor Supplementation

• AHA Guidelines + PALS• Robert’s and Hedges – Procedures in EM• Mattu - ECGs for Emergency Physicians• Up-to-Date• Goldfrank’s Tox Handbook• Knoop – Atlas of Emergency Medicine• Toronto Notes (no joke)• Something for Ethics and Clin Epi• FOAMEd

• Top 10 list papers– Review course material should suffice

• Do lots of practice orals• Schedule time at the end to actually sit down to write practice exams

FINAL THOUGHTS• There are no shortcuts – you must read Rosen’s• Ironically, Rosen’s itself is not the best text

– The most efficient way to supplement is with online FOAMEd content• Many people make notes – written vs. electronic vs. cue cards• The exam is reasonable and they want you to pass• Discover early if you struggle with oral exams• Anxiety and panic are normal, especially in the new year as you

are tired but still have a long way to go• This process will make you a better doctor• Think of how good it will feel to be done• Don’t forget about your family and friends

– they will keep you grounded and sane

One last thing

• Unexpected things happen

Photo credits

• http://www.thedailytouch.com/dailytouch/1700-students-sit-an-open-air-exam-in-china/

• http://www.theguardian.com/education/2013/feb/11/new-generations-condemned-educational-failure

• http://sites.tufts.edu/emotiononthebrain/2014/10/10/disgusting-the-role-of-disgust-in-ocd/

• http://www.olddominionequine.com/equine-services/purchase-examinations.html

• http://www.bloggersideas.com/tips-for-choosing-color-for-logo-design/