Tips and tricks for getting through the second part
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Second part exam preparation
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Tips and tricks for getting through the second part
- 1. THE CICM FELLOWSHIP EXAM “The Second Part”
- 2. Outline: 1. Understanding the process 2. When to sit 3. How to prepare 4. Written tips 5. Clinical tips 6. On the day tips
- 3. The Process
- 4. From the Candidate’s Perspective ❖ Eligibility ❖ Decide on date ❖ Application paperwork (need 4 Hot Cases) ❖ Payment by closing date ($$$) Written Written2 M
- 6. What we receive ❖ Representative ❖ Well Standardised ❖ Competence based assessment
- 7. The grass is not greener elsewhere ❖ Resuscitation simulation - ACEM ❖ Minutiae of RACP ❖ Physics of ANZCA
- 8. When and how to sit
- 9. Job Family LeaveLife Paid Exam Fee
- 14. Location and Job ❖ Does this really look like an ICU
- 15. Study Group
- 16. Consultants ❖ Ensure on board ❖ Pick the right people initially ❖ Then variety ❖ Finish with confidence
- 17. Resources
- 18. Resources
- 19. Courses ❖ Melbourne Clinical Exam Course ❖ Wellington Course ❖ Adelaide ‘Tubs’ Course ❖ Canberra Course ❖ Brisbane Course ❖ Sydney Course 1 Early 1 Late
- 20. Remembering & Recording OR Recording Presentations for the Hot Case
- 21. Spaced Repetition ❖ Evidence based ❖ Tools available ❖ Vivas & SAQs https://lifeinthefastlane.com/learning-by-spaced-repetition/
- 22. The Written
- 23. The Curriculum 1. The previous questions 2. The CICM competencies statement 3. Overview in short texts & online examination notes - LITFL CCC, Deranged Physiology
- 24. Timetable ❖ Ensure content is mostly covered ❖ Satisfaction at getting through core knowledge ❖ SMART goal setting
- 25. Where the money is ❖ Quantitative Breakdown - % on each topic ❖ Bang for buck - Communication, EBM, Radiology, Statistics, Trials, Airway, Ventilation, CRRT, mechanical support. ❖ Hot Topics - Controversial topics in ICU, In the literature this and last year ❖ Adapt to personal weaknesses
- 26. The Written - SAQs ❖ Do most of the past questions. ❖ To time ….. really?……from the start? ❖ Reflect and rewrite SAQ’s ❖ Compare ❖ Multi-source feedback ❖ 1-3 months to time
- 27. Timing 15 * 9.5 = 142.5 min Exam = 150 min = 7.5 min remaining 9’30”
- 28. Answer the question “Candidates are advised to read the questions carefully and thoroughly and ensure they answer the question as asked and address all parts of each question. Candidates are reminded to make sure their writing is legible and to avoid using non- standard abbreviations.
- 30. The Clinical
- 31. Training for the Clinical ❖ Just another day ……. ❖ Incorporate into daily clinical practice ❖ Regular hot cases ❖ Examine like a physician trainee ❖ Round like a consultant
- 32. The Hot Case End of Bed Room Infusions Monitors Ventilator Other Equipment Specific Examination to answer the question Chart and trends Investigations and discussion
- 33. The Presentation 1. Answer the question 2. Outline examination findings and explain how they correlate to your conclusions 3. Make it obvious you know what the big issues are, what is interesting, and what the questions will likely be. 4. Be flexible in presentation style 5. Deal with uncertainty 6. Speak like a consultant
- 34. The “Structure” Dilemma Reasonable Effort Paralysed by structure Improving but still uncomfortable Inflexibility - this isn't working - abandon Residual structure effect Improved & Flexible Performance
- 35. Vivas ❖ Hard to train/write/get committed examiners ❖ No Excuse for Radiology, Procedures, Communication, Resuscitation, algorithms and airway skills ❖ Write your own informed by SAQ, College Reports ❖ Tips: ❖ Verbal efficiency - get your list out with the minimum of words ❖ Back to back
- 36. On the day ❖ Rest ❖ Positive visualisation ❖ Feed off successful questions ❖ Note you body language ❖ “Fake it till you make it” - Amy Cuddy
- 37. The End
Editor's Notes
- Thanks I’d like to bring you an assortment recommendations from others and myself - there are many different approaches and no one way works for everyone - but hopefully everyone can find some useful tips. Background I did the CICM fellowship, around 2 years after the ACEM. Limited time -Young family, new job, 2 small children I placed a large emphasis on time efficient study and did pass despite a short lead in time so hopefully some of these tips will work for you.
- Quite simple Confirm eligibile Deciding on the right date for you Ensuring that you have the paperwork for the application complete - note have to have completed 4 hot cases already. Looking at the time lines - you really have to have started preparing for the hot cases before the written.
- For the examiners its not simple: Mary Pinder is chair of the Second Part Examinations Comm and was kind enough to do a question and answer session on the fellowship exam which is full of background on the process and tips. 400 hours of work for the Chair per annum 7 FCICM Examination Committee 50 Examiners - 3 workshops/year 8 admin staff for the clinical Logistics +++
- Just in case you were thinking of jumping ship……
- It is a bit of a cliche but it needs to be said - you do need to commit to get this exam done in the first attempt. Your need to like up all facets Get committed and do it at the right time for you.
- What is the right amount of time do I need to prepare: Everyone has busy life. Study smarter and the box is smaller Reflecting on work and treating cases like examinations adds to this But overall The exam takes up a finite amount of space. You need to work out what proportion you can handle and how long you want to draw the process out. Give a lot for a short time Give a little for a longer time What works best for some does not for others. a range from 1.5 years to 6 months. Of the additional items some have to give unless you are willing to stretch the study time
- What is the right time and how long do I need to prepare: Everyone has busy life. Study smarter and the box is smaller Reflecting on work and treating cases like examinations adds to this But overall The exam takes up a finite amount of space. You need to work out what proportion you can handle and how long you want to draw the process out. Give a lot for a short time Give a little for a longer time What works best for some does not for others. a range from 1.5 years to 6 months. Of the additional items some have to give unless you are willing to stretch the study time
- What is the right time and how long do I need to prepare: Everyone has busy life. Study smarter and the box is smaller Reflecting on work and treating cases like examinations adds to this But overall The exam takes up a finite amount of space and arguably there will be impingement on arguably more important, and certainly more enjoyable aspects of your life. You need to work out what proportion you can handle and how long you want to draw the process out. Give a lot for a short time. Give a little for a longer time What works best for some does not for others. a range from 1.5 years to 6 months.
- Needless to say….. Eliminate the unnecessary This is an Multinational netflix study showing which are the most binge watched TV series. Impressivly the average time for one of these series to be watched is 5 days. The chart further divides series in sessions over more or less than than two hours! Needless to say - Watch out if you start watching those series in the thriller or horror genres on netflix.
- The examination is of what you do everyday It requires exposure and rehearsal to think and act like an ICU consultant Communication practice to staff and families Very importantly It requires you foster and maintain relationships with your mentors and examiners Could you keep these skills and relationship working in anaesthesia or medicine? Why would you work elsewhere? …….but it has been done.
- Work for some Can break the monotony Motivation “Save time” Alternatives - Skype study, Join ANZCA fellowship training, ED Fellowship Training - especially vivas, RACP How to examine
- There is a wide variety of online resources that are fantastic for taking topics into digestible chunks and do a good job of covering the curriculum. I did primarily use these as a base for my study. However, I did discover the Ex in IC and other txt books later and would recommend these as a excellent start point.
- Previous exam reports - standard, structure, common recurring trainee mistakes
- Early for approach to study, standard setting, contacts, and motivation Later to reassure/remotivate on track. I did mine in March and July with sitting in August.
- Write your notes or type/copy Educational Theory - Encoding learning or external storage and spaced repetition My Approach - concepts and management priorities written/schematics, questions written, major resources collated and pasted. Really handy to have accessible notes to assist in long term learning Recording was an interesting method suggested to review and critique your own presentations. I found it difficult and painful to listen to, and always found I performed better with the recording off.
- Differential diagnosis of Fever, Coma, NAGMA Management Options for: TBI, Difficult ventilation EBM supporting current practice
- Insert Chart with ticks Specific Measureable, achievable, relevant, and time specific
- Four approaches, Use all Quantativly calculate which areas have the majority of questions Which areas have some questions but are easily covered in a short period. What are the likely critically evaluate questions.
- To time is over emphasised - get the structure and knowledge concurrently Reflect and re write Compare with others Show your SAQs to others for different opinions In the month leading to the written - to time
- Tell ED Fellowship Exam Story. I know first hand how important answering all parts (last question on the ACEM exam), seemed very short, only one AP xray of wrist with an odd angled lunate and scaphoid fracture. I though at the time odd to not give a lateral X-ray, voice in head something NQR, in my assessment wrote - I would be worried about scapholunate dislocation, would need a lateral, and what I would look for. Closed question book and on the back cover was printed the key xray. Tears and swearing - encouraged that later after the FE clinical overheard an examiner laughing about the written and how after much discussion they passed the trainee who didn't close the book!
- Just another day ……. Incorporate into daily clinical practice Regular hot cases Examine like a physician trainee: detailed, smooth, efficient,. Round like a consultant -What are the big picture issues and their management.
- 4 sections to the HOT CASE - and the majority of information (like in practice) can be gleaned from the end of the bed. Specific examinations for each system need to be learned to the point where they can be adapted to suit the case and clinical question posed and cope with patient position restrictions etc. Relevant additional information should be sort from the charts and bedside investigations as you would in clinical practice May receive some investigations before presenting and leading onto discussion.
- Answer the question Outline findings and relationship to conclusions - really depends the question, the case, type of examination findings, whether you speak as you go, presentation style, and whether the diagnosis is known or a differential/issue list required.
- Learning structured presentations in the HOT case: I found that I went thorough several stages of grief in learning how to present my long cases. Initally I thought that it was a problem with my structure. However, having talked to a few other trainees the pattern seems to be:
- How much training for the viva’s depends upon how well the initial SAQ information was learnt and retained and your performance under stress. Obtaining practice vivas for training is difficult No excuse for being underprepared in predictable questions Can write yourself and for each other informed by college reports SAQs etc Vivas are very time pressured , point scoring ability depends upon getting your information out quickly, appropriately ordered, and signposted so the examiners don’t miss anything. Practice verbal efficiency in answers is vital.
- Finally - on the day vital to ensure adequate rest Visualise winning and feed your confidence off successfully answering questions Note your body language - important for both how you feel about yourself as well as what the examiners see Finally if you are nervous and having trouble - watch this TED talk, strike a power pose and “fake it you you make it”