All posts by anzcaadam

MCQ’s

ANZCA’s disappointing position on sharing MCQ’s (that they have explicitly banned it) make sharing resources here very difficult. (see my advice page).

I would encourage candidates to search for past questions (either locally or on the internet) to guide their study.

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Anaesthetic Viva’s

The bulk of knowledge required to succeed in the Anaesthetic Viva’s can be found by studying the notes in all the other sections. That and a lot of practise of the “ANZCA style”. However, I have made some Viva specific notes which hopefully will be of use. These were sourced from various texts, and local department teachings.

All files are in downloadable .pdf format:

Anaesthetic Crisis Handbook (see anaestheticcrisishandbook.com)

Risk

Viva problems

Viva statements

ANZCA Documents

This section contains summaries of various ANZCA documents. The Professional document summaries were done by Dr Joe Dieterle & Dr Mark Woolley with absolutely no input from me. The Blue Book & Welfare Summaries were a joint effort in our study group. Thank you to Dr James McAlpine, Dr Petra Van Der Linden-Ross, Dr Manson Ku & Dr Ash Kahawatta.

All files are in downloadable .pdf format:

2015 Blue Book Summaries

ANZCA Professional Documents

Welfare Summaries

Fundamentals

The section contains notes focused around Anaesthetic core topic area’s. They are useful for both MCQ, SAQ revision and Anaesthetic Viva revision.

These notes are authored from numerous sourced. These include work by myself, or in collaboration with previous notes from Dr Jeremy Fernando’s and Dr J Pigou. Extra material has come from various sources including the Oxford Anaesthetic Handbook, as many relevant CEACCP articles that I could find (there were a lot), ANZCA documents, NZ Blood Modules, ACCAHA Guidelines and local department published documents & group teaching. They have also been supplemented by learning and information from the Auckland Revision Course.

Many thanks to all the contributors.

All notes are in downloadable .pdf format:

Blood:

ACCAHA Guideline

Airway

Day Stay, PONV & PACU

Pain

Professional Matters

Remote Anaesthesia

Statistics

Medical Viva

A few different resources here.

I’ve written an advice document. Dr Manson Ku has collated a list of diseases to study based on all the previous patients used by examiners for med viva’s by ANZCA. Dr Chang Kim has written an excellent summary of key information and salient examination findings for a number of medical conditions that commonly come up (NB you will see from Dr Ku’s Topic list that Dr Kim’s notes don’t cover every disease. The remainder can be found throughout my other notes in Medicine and SSU categories).

I have also provided the examination skills notes I wrote way back when in medical school (over 10 years ago now – goodness). This was all i used in preparation for formulating my planned exams. I have included notes on tailored exams which reach across different systems eg thryroid, or diabetes. However, we were told specifically by current examiners that you should not be asked to do a multi-system exam anymore. Instead you should be directed to perform a single system exam eg Cardiovascular or Respiratory or Musculoskeletal. You only have 3-4 minutes after all.

General study from SSU’s and Medicine categories is vital for the “discussion” part of the medical viva.

The combination on this page is all i used for Med Viva study.

All files are downloadable in .pdf format:

Med Viva Advice 

Med Viva Topic List

Med Viva Disease Summaries 

Examination Overviews:

Multisystem Exams:

Medicine

The section contains notes focused around medical diseases. They are useful for SAQ revision, MCQ revision and medical viva revision.

I took Dr Jeremy Fernando’s previously written notes and updated and added to them. Extra material has come from various sources including the Oxford Anaesthetic Handbook, as many relevant CEACCP articles that I could find (there were a lot – & thank you to Dr David Prior for collating an amazing database) and local department published documents & group teaching. They have also been supplemented by learning and information from the Auckland Revision Course.

All files are in downloadable .pdf format:

CVS Diseases

Endocrine Diseases

Genetic Diseases

Haematology Diseases

Liver Diseases

Neuro Diseases

Psych Diseases

Renal Diseases

Respiratory Diseases

Rheumatology Diseases

SAQ’s

They are useful for both SAQ revision and medical viva revision.

As I mentioned in the advice section I didn’t do a lot of specific SAQ focused practise. However, my study group did do some work answering previous SAQ questions. I have also written a general advice document. Many thanks to Dr Manson Ku, & Dr James McAlpine for their help in this section.

All files are downloadable in .pdf format:

SAQ Advice

Mega SAQ – (Index Key: grey/crossed out = repeat Q, yellow = not done)

Recent Poorly Answered SAQs

SSU’s

The section contains notes on individual special study unit topic areas. They are useful for SAQ revision, MCQ revision as well as medical viva revision.

I took Jeremy Fernando’s previously written notes and updated and added to them. Extra material has come from various sources including the Oxford Anaesthetic Handbook, as many relevant CEACCP articles that I could find (there were a lot – & thank you to Dr David Prior for collating an amazing database) and local department published documents & group teaching. They have also been supplemented by learning and information from the Auckland Revision Course.

All files are in downloadable .pdf format:

Cardiac

Elderly

Endocrine

ENT

General Surgery

Gynae

ICU

Max Fax & Teeth

Neurosurgery

Obesity

Obstetrics

Onco-Anaesthesia

Opthalmology

Orthopaedics

Paediatrics

Plastics

Regional Anaesthesia

Thoracics

Trauma

Upper GI

Urology

Vascular

Advice

Many of you may be coming to this site having used my other Primary Notes site. Congratulations on getting through your first exam, one more hurdle to go!

The motivation and ethos behind this site is very much similar to my previous. It’s been a tough year personally and if my work can helps others to navigate through with a little less stress I’d be very happy.

I asked many learned colleagues before settling on my study plan for this exam. Interestingly people had wildly different approaches. In contrary to the primary exam, a lot of resources already existed in my department. Furthermore, I decided quite early that my systematic approach to covering the syllabus as for the Primary was untenable. There is simply too much to cover. As ever, I believe high yield study is the key. I see little reason to waste hours wading through large text books full of irrelevant prose to find morsels of useful information.

It is a bit of a leap of faith deciding on a study plan and holding the course. In retrospect I am very happy with my decisions. While I have strong opinions on the following advice being good, it is of course my own opinion and everyone has different needs and routines in order to learn.

Can I just thank again, all my amazing colleagues who have contributed to the resources on this site. This site is a far more collaborative work than my other sites. I simply wouldn’t have had time to assemble all these resources alone, and thus I’m eternally grateful.

This exam has many different components which require different study approaches. I’ll go through them.

SAQs

Contrary to the Primary I actively decided not to spend my time learning previous SAQs. They simply do not repeat like the Primary. The syllabus is so big there is no need for it. Furthermore the required structure needed to answer the question is not as rigid. That said we did do numerous full practise exams to practise technique and build up hand strength in our hospital teaching time. However, I spent literally zero time writing out practise SAQs privately. This surprises people, but this exam is not the Primary.

Instead broad and deep studying of all the corners of our syllabus is needed. They may ask you anything. For this I used the notes found under the categories SSUs, Medicine, ANZCA Documents, Fundamentals, Tools. There is a lot of information in here, I tried to learn it over and over.

MCQs

A (hopefully correct from memory) quote from a senior examiner at a study course I attended….”ANZCA has deemed that it is in violation of trainees learning agreement to share past MCQs. Yet the way I advise you to study for the MCQs is to learn past MCQs via the black bank”. You can imagine my “entertainment” from this comment. It seems to me that the MCQs have become a cat and mouse game between examiners and candidates. Some of the questions they now ask are so obtuse and bizarre that their is little point trying to study specifically for them, outside of doing past questions. Because of this “learning agreement” I will probably not share any MCQ resource, but I would encourage local departments to develop such a thing. All I did was study past MCQs in the final few weeks prior to the exam. My general learning from SAQ study was more than enough to supplement this.

MEDICAL VIVA

I honestly don’t understand the relevance of this component of the exam to being an excellent Anaesthetist. Examiners will spin the line that “this is what we should be doing everyday in clinic”. I would beg to differ but of course its another step that requires conquering. This is an outpatient medical exam focused on chronic illness and it’s impact on the patients quality of life. Your success in this component requires practise, structure and a highly stylised confident-oozing technique. If you do well here, it could be the key to getting a Anaesthetic Viva invite, so ignore it at your peril. My study plan was to gain brief knowledge of medical conditions which have come up in the past. You need to practise how to extract as much high yield information as possible from the patients in as little time as possible. You also need to develop an internal clock (given ANZCA’s recent ridiculous banning of personal watches in this component) to know when to transition from history to exam. Your exam needs to look slick, be systematic and as ever be quick. You should be able to synthesise your findings into a short focused summary, and then be able to talk through investigation findings and general knowledge about the patient’s diseases.

Whatever you do, trust your exam findings. Don’t lie in order to assimilate them into what the patient told you. The patient can often be poorly informed. If you find something unexpected then say so, and explain to the examiner that it is unexpected and you would like to see some investigations to understand this further.

We were told at least one of the two patients would be a cardiac or a respiratory patient.

ANAESTHETIC VIVA

Success here is based on a combination of general knowledge from your SAQ/MCQ study, targeted VIVA study for managing crises, and a lot of practise. Practise really is important. It was not abnormal for some of my colleagues to do 30+ formal practise vivas prior to the day. There is an ANZCA style to delivering your knowledge to the examiner which is difficult to explain but becomes clear as you practise with senior colleagues. It’s also useful to get honest feedback, or even video or record yourself doing viva’s, in order  to understand and address your performance foibles. Synthesising your knowledge and delivering it in a categorised and confident manner can be hard.

My last bit of advice would be to practise doing Viva’s back to back. Everyone will have a bad Viva, and being able to put it behind you immediately and regain confidence at the ring of the bell is vital.

SUMMARY

That’s it folks. I really hope this website helps and educates. Make sure you factor in some time for yourself and your loved ones, away from this debacle. After all, your personal physical & mental health as well as the health of your relationships are more important (the welfare group even say so). Good luck! Adam.