Category Archives: 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.


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.


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.


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.


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.


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.