Comforting Words

Tuesday, 30 May 2006

In the last 3 weeks results for the latest rounds of written exams, case histories and clinical exams have been posted on the college website.

Writtens:

82 passed

44 failed

65% pass rate

For the Case Histories:

Psychotherapy case: 20 out of 23 passed (87%)

First presentation case: 21 out of 25 passed (84%)

And for the Clinicals:

146 candidates sat, and 71 passed

pass rate: 49%.

Congratulations to the successful candidates, that's really well done!but for the 126 registrars walking around liking some kind of acute wound I posted this information on Auspsych in search of comforting words and this is what they said...

Dear Auspychers,

51% of candidates just failed the RANZCP Clinicals, A proportion ofthem were repeat candidates,Being a registrar is hard, incredibly constraining and this cohortare negotiating a chaotic and confusing training course change over.I imagine they are gutted...can anyone think of anything nice to say?I'll publish these comments in The Responder.Cheers Deet

Richard Baker sent a quote:A common mistake that people make when trying to design somethingcompletely foolproof is to underestimate the ingenuity of completefools.

Douglas Adams

Michael Block wrote:Hi Deeta

3 possibilities:1. why are we selecting the wrong candidates to the trainingprogramme? Why stuff around with people's lives when they can beproductive members of the community in other areas of medicine?

2. What sort of training environment are we exposing our futurecolleagues to if it can't equip them with the skills to pass the exam?

3. Good examination skills are not an adequate measure of goodpsychiatrist skills.

Personally, I think that the problem is both 2 and 3. My advice is tostick with it, once you pass you can knuckle down and learn the realskills required to be a psychiatrist.

Cornelis Greenway wrote:

Dear candidatesDon't sweat it. I failed, then passedDidn't really make any difference.Good luck next time round.

Corn

ps you aren't necessarily stupid, incompetent unlearned...you just failed tosatisfy the examiners

Erin redmond wrote:

Unfortunately, Corn's PS is the bottom line - with the OSCE's there are tasks that must be performed, and if they are not, then the candidate does not pass that section of the examination. It is a question of time management, and I think this is probably where many canditates fell down, rather than lack of knowlege.It is truly awful to fail, but many excellent and competent psychiatrists don't get through the first ( or even second! ) time. The other trick ( I know this is stating the obvious), is how to manage your anxiety. I had some hypnotherapy and used a tape b/n exams, and this was really helpful. Other candidate who knew their stuff but failed more than once, videotaped themselves then critiqued their performance and tried to learn from this.Have a bit of a break from the study, don't take it too personally, remember that this happens in all the colleges of post grad med - there are always surprises - some great canditates fail and others who don't seem to be particularly outstanding - pass.Good luck with your studies, and next time round.Erin

Margaret Philip wrote:

Only the obvious: that none of the public mental health service wouldrun at all without you; that most of us in private practice rely oncompetent registrars at the end of the phone if we need someone inhospital; and that I at least learn as much from my colleagues intraining as they do from me. Hang in there!Margaret , who was a very old trainee not long ago and had several goesat the writtens Margaret

Philip Morris wrote:

Deeta, I too am sorry to hear about your experience. However, keep ongoing! Persistence will be rewarded, and speak to some trusted 'elders' whocan give some caring but dispassionate feedback on performance. A failurerate of over 50% sounds like a cause for concern for the training andexamination committees of the College, although I suspect that occasionallythe failure rate might go over 50% in one exam. But this should not be acommon experience. I too am critical of the current training experience;training registrars predominately in the public sector is too narrow anexperience now - somehow training needs to be widened further to privatesector and other locations, and the exam process needs to be simplified - Iwould replace the current marathon with a comprehensive multi-choice examfollowed by two observed clinical interviews (similar to previous Am Boardof Psychiatry and Neurology exams) at the end of 'basic' training with asimilar approach (but more specific) at the end of 'advanced' training.But, hey, what would I know! All the best. Philip Morris.

Lois Achimovich wrote:

No Deeta, I can't think of anything nice to say. The results show that thetraining is deficient.Lois A.

Brian Boettcher wrote:

I think we are far too anal in this area in Australia and in USA theattitude is that if you have been selected you should be passed unless youhave really suddenly had a personality change. Why on earth do you putsomeone through this taruma and training to fail them. TAFE takes the sameattitude - if some one of a lot of them is not doing well it is the fault ofthe trainers or the selectors!!!

If the registrars are being trained in another country other than NZ orAustralia then it may not be the College fault but THIS IS NOT THE CASE. (sorry for yelling). I saw two of the very best potential psychiatrists, whoI had worked with, fail in their final vivas - I would have been more thanhappy to have any of them treat me of my family> What is wrong with you allin the cpllege - I thought you had got rid of the triksters.

Brian

Julian Parmegiani wrote:

I don't know whether comforting words would help everybody. There areprobably different ways of reacting to stressful events. This depends ongender, personality, cultural factors, past experiences etc.

As a male member of the species, I tend to externalize distress. In otherwords, I'd feel pretty angry failing the exam, specially if I knew my stuff.

1. Your posts suggests registrar training is in shambles (to call it a timeof transition is being too kind).

2. The exam process is not perfect.

3. Most examiners of course are well-meaning, knowledgeable and hardworking. A handful however get it wrong.

4. The exam is largely a test of compliance, not knowledge. Registrars mustgo through the motions, kowtow to the grand-poobahs of the college, and doone final revision of all the stuff rote-learnt over four or five years.

How's that for externalizing?

Julian

And Andrew Beckworth wrote:

Just to let you know South Australia once again has done very well in theexams. Our pass rate for the vivas was 90% i.e. 9 out of the 10 traineespassed. This is due to good training as well as good candidates. SAconsistently achieves excellent results. Consultants in SA give a lot oftime to helping registrars pass. Many are willing to undertake practiceOCIs in full which means settling aside the best part of two hours per OCIcase. Many consultants will do several of these prior to each exam. Thelocal training body, the SAPTC, does a very good job in providing intensiveteaching for the writtens and the Viva on a weekly basis.

My understanding is that the OCI is usually what determines if a candidatepasses the viva, not the OSCE. i.e. most people who pass the OCI pass theOSCE but there are a number who pass the OSCE but fail the OCI. It is veryrare to pass the OCI and fail the OSCE. For those who do not know you mustpass both to pass the viva and if you fail either the OCI or the OSCE youmust re-sit the whole viva next time.

I was not involved in designing the exams etc but I know some of the peoplewho were and they worked very hard to make the process fair and staticallyvalid. I understand that the number of stations in the OSCE was chosen onstatistical grounds. A large amount of time goes into the whole process ofthe exams most of it unpaid.

Regards

Andrew Beckwith