Part Timer
Passing the clinicals as a part-timer
Thursday, 10 April 2008
Anne Wand
I was a part-time trainee (3 days/week) when I sat the clinicals at the end of 2007. It's definitely a challenge to juggle practice exam sessions with a clinical load and family life, but it can be done. I know many part-time trainees find the whole exam prospect daunting and put it off and off ..... I hope to impart some useful tips for how to get started, get into it and through it.
I found a study partner about 6-7/12 prior to the exam who was prepared to commit to a similar (realistic) amount of regular preparation time. Having 2 people studying together I think was ideal as we each had ample opportunity for practice and could sit in on each other's practice exams with consultants. We were also friends with thick skins who encouraged honesty and criticism in evaluating each other.
We separated preparation in OCI and OSCE. Did the OCI practice while at work (we were fortunate to initially be in a term where you could escape for 2hrs to do an OCI) and found that being honest with our supervisors about the need to have a weekly OCI practice (they agreed without quibble). I also found it useful to use my supervision to present my 7min spiel and then have the viva. My first supervisor was an examiner with much experience and who inspired intimidation, which was actually good early on and improved my formulations quickly. I also practiced OSCEs with my supervisor in this time. It was useful to get this practice with an examiner, as you don't really get the value of an examiner/consultant perspective for this part of the exam. It really helped me look past the small print and see the main point (or what was newsworthy as he liked to say). Being part-time people tend to resent you being off the clinical job, so using supervision time for exam preparation is a great was to get some practice in. If you can convince your supervisor to use this time to do an OCI or 2 (and at a different venue to where you work), even better.
I was surprised that work was reasonably understanding at my having time off the ward to do practice exams. I tried to make exam practices at the start or end of the day so as not to waste too much time with travel or to be too conspicuously absent (as I find you already are when part-time). To do this you really need to book the mock examiners a coupleof months in advance, they run out of time in the last 2/12 and there are some people (esp past/present examiners) whose feedback is really invaluable. Having said that I did end up coming in to work earlier most days (but I had a busy clinical job anyway). I was also unable to go to all the training sessions that the area provided- some were on my days off and i couldn't arrange a babysitter. It's great if you can have your say about available times for any area-arranged sessions, but this depends on the majority and the consultant running the group. Be selective in what you go to. You don't have to go to everything and it doesn't make much difference in the longrun. Get a study-buddy to copy you some notes or give you a rundown of really useful sessions you couldn't attend.
Back to what my study partner and I did.... We made a list of major diagnoses and feared cases and made sure we saw and thought about at least one OCI from each (for us this incl forensic, anxiety disorders, eating disorders, rehab- stuff we didn't see often). We also made a list of broad OSCE topics after combing through previous exams to see what was common or repeated. Totally useless with the OSCE we had in NZ, but we felt more confident, and that is the main point. We did one topic a week over a 2-3hr session one regular night and that was it. We also felt comfortable enough to practice all the main physical exam OSCE stations on the ANZAPT and College websites. It's to be recommended just to look slick and confident.
I have a baby girl and didn't have time for thorough note making and textbook rereading on week nights and weekends. I'm not sure you need to do that anyway. What I observed was the more people hit textbooks the more stressed and overwhelmed they became. What I did do was rewrite my formulations and management plans if they were dodgy the first time within a few days after doing them. I used these as a springboard to look something up (e.g. DSM criteria, evidence level for mx of a partic condition, aetiological/risk factors for the condition). Institute notes (NSW trainees) and summaries from the writtens were useful here and saved time. We didn't do any OCIs on weekends or after hours- too tired and it's important to see your family as they can help you stay level headed and based in reality. The exams are not everything.
Don't forget to exercise! I found it a great way to relieve stress (especially after a bad OCI), maintain a normal routine and feel generally good. This exam is very much about feeling confident and positive about yourself, perhaps more so than having a wealth of knowledge.
Finally, I took my family with me to the exam in NZ and this was the best idea ever. I still had to change nappies, bath and cook for the baby, which meant less time to get neurotic, muddled and freak out. It was also reassuring to be doing normal things and to have their support.
So the take home message to part-timers in particular is to go for it. You can do it and pass and do not need to devote all your waking hours to preparing. Talk with your supervisors early about the tme you'll need to prepare and get supervision set up to meet YOUR needs. Go in there chanting that you will pass (my songs were eye of the tiger and rocky), not "give it a go". It's not fun and you only want to do it once. Good luck!