1. The Exam NRC 2015 Adam Szulewski BSc, MD, FRCPC, MHPE Assistant Professor Department of Emergency Medicine Queen’s University

2. What to expect Fifth year Studying Tips Written Exam Oral Exam Final Thoughts

3. Fifth year Sucks But… You become a better doctor by the end

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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.

10. 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

11. 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

12. 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

13. One last thing Unexpected things happen

15. Photo credits http://www.thedailytouch.com/dailytouch/1700- students-sit-an-open-air-exam-in-china/ http://www.thedailytouch.com/dailytouch/1700- students-sit-an-open-air-exam-in-china/ http://www.theguardian.com/education/2013/fe b/11/new-generations-condemned-educational- failure http://www.theguardian.com/education/2013/fe b/11/new-generations-condemned-educational- failure http://sites.tufts.edu/emotiononthebrain/2014/1 0/10/disgusting-the-role-of-disgust-in-ocd/ http://sites.tufts.edu/emotiononthebrain/2014/1 0/10/disgusting-the-role-of-disgust-in-ocd/ http://www.olddominionequine.com/equine- services/purchase-examinations.html http://www.olddominionequine.com/equine- services/purchase-examinations.html http://www.bloggersideas.com/tips-for-choosing- color-for-logo-design/ http://www.bloggersideas.com/tips-for-choosing- color-for-logo-design/