• Dr Sally Ayesa

When it's your turn

It is an odd time in exam preparation when the last group has just sat the exam and received their results. All of a sudden you realise that it is your turn next and there are no more colleagues ahead of you. There is no more buffer and no more excuses. This is your time.

For me it gave a bit of a crisis of confidence. The biggest stumbling block is that you find yourself comparing your tutorial performance and knowledge to those who have just sat the exam. It is easy for the self doubt to creep in, feeling that you will never be able to turn in as polished a performance as those you witnessed in your colleagues. The most important thing is to remember that they started out just like you, and it can be easy to forget how far they have come because it has happened gradually.

So what can we do to get ourselves motivated and prepared in the early days?

1. Ramp up the reporting

Increasing your reporting volume - especially for more complex modalities and conditions - is one of the best things you can do to help prepare for the written exams, and the vivas. Take note of important and non-important findings across the modalities so you are able to zero in on pathology in practice and your exam cases, providing a more streamlined approach. Learn the language of the modality and apply it to practice exams.

2. Be brave and put yourself forward in viva tutorials

Most training sites will have you up the front presenting cases now. Some sites (including where I trained) use the time between last past sitting and the next round of written exams to spread the cases among the more junior registrars (which certainly has its merit as it allows the next generation to start building structure and technique). Be kind and share the education by all means - but make sure that you are getting at least a handful of cases each tutorial. Remember that this is your time. If you are offered small group or one-on-one sessions, take it.

Leaving the preparation of the viva exam to after the written exam can shoot you in the foot. The written exam is becoming increasingly complex, with a higher failure rate than in years gone by. Consultants and exam tutors will have complicated cases saved in their viva sets, and there is great benefit in getting you eyes on some more complicated pathology in the weeks leading up.

3. Start thinking about developing your viva technique

I am a firm believer that developing viva technique is not something that can be left until after written exams. I have seen some excellent candidates pour themselves into written exams, saying that they will deal with viva technique after the written exam is over. What I see if that it can then take weeks for a candidate to build a technique from the ground up, losing preparation time when it should be more about building knowledge than developing style.

If you already have the basic building blocks to refine your viva voice, you can start to do the real work of experiencing the breadth of cases and refining your approach. You will find yourself already ahead of the game.

Also remember that good viva technique includes being able to hone in on important abnormalities and present the findings in a succinct and relevant description - a good skill which also translates into written exams.

4. Dedicate time to the multiple choice exams

There is no way around the intensive bookwork required for the MCQ exams - and it needs to begin as early as possible. You just have to pour yourself into it. It can be hard for medical imagers to get into a textbook which is full of words, as we are all inherently visual people (or at least I am). To prepare I worked through MCQ banks with my study group, then went home and typed up extra notes based on what we had worked through. This allowed me to stay high-yield and potentially work on areas I was struggling with (identified in group sessions and viva tutorials). I read book chapters covering topics I needed to know more about, rather than whole textbooks cover-to-cover, as I would become bored.

Everyone studies and learns in different ways. Don't try and copy someone else's style to the letter if you aren't finding it works for you. Think back to exams where you have been successful in the past - perhaps RANZCR Part I or final year university. For my year 12 exams I had highlighters and coloured pens - so all of my radiology part II notes were highlighted and covered with notes written in pink and purple and orange.

5. Give yourself a break and ask for help

Don't be too hard on yourself. If you started your preparation already ready to sit the viva, you have peaked too early. Be prepared to make mistakes. You will never again have a time in your where you will experience such rapid growth as a radiologist. Embrace it.

Be kind to yourself and seek help if (when) you need it. Confide in a mentor or your study group, and remember that people want to help. As Dumbledore says - "Help will always be given at Hogwarts to those who ask for it". My door is always open.

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