Every registrar I speak to wants to know: What’s the trick in passing Fellowship exams. That’s a good question – with a complex answer. It’s similar to “How do you eat an elephant?” The answer is “One bite at a time”.  How do you pass the exams? One step at a time.

Unfortunately, it’s not the answer people want. Registrars want me to just tell them what to read and which exam prep course to do.

If only it were that simple!
But read on! From our experience, we’ve got a few tips and suggestions. We’ll discuss an approach to passing you fellowship exams in 5 steps.

You can listen to the recording, and read the transcript below.

To be realistic: there’s no “one answer fits all”. A lot of research has been done looking at factors contributing to exam success, and there’s one thing they all have in common: all the research says… it’s complex! You’ll probably need to do a bit of everything mentioned here: more in some areas, less in others. But you’ll need to tailor your approach to your own style and needs.

And I’ll be honest up front: there don’t seem to be any shortcuts! Passing fellowship has multiple factors to consider: candidate factors, exam factors, training factors – we have control over some of these and not others. You need a solid foundation and adequate knowledge, and then demonstrate skills and attitudes that show that you’re safe to practice independently in general practice.

Firstly, a lot depends on past experience and training. If you’ve been trained in a system where didactic teaching was the norm, you may need to learn a different way of thinking! But don’t despair – it’s possible to relearn! There are multiple resources around assisting with this. Speak to your medical educator who will be able to help guide you.

If you’ve spent a lot of time working in hospitals, you’ll need to spend time in general practice and consider and discuss how the approach differs in general practice. Registrars who have spent time specialising in other fields can sometimes have difficulty re-focusing on holistic general approaches. But don’t despair – it’s possible to refocus! There are resources for this too. Speak to your medical educator.

And then there’s language. For some, English is their second, third or even fourth language, and the nuances and subtle differences in meaning can be tricky – and this plays a role! But, again, don’t despair! Help is available for those who would benefit from it.

And before we even get to step one, we also need to consider how your work, family and other life issues could affect your preparation – you need to maintain balance throughout this process to ensure you can make it to the end. Take time out from work to relax, not just to study for exams. Something as basic as sleep is important! Without adequate sleep the neural connections are not as strong.

All this plays a role, before you even start studying and preparing for exams!

So, with all that as background to consider, we come to step one: you need the knowledge. That means hours and hours and hours of studying. Set aside dedicated time for your study each day, every day.

General Practice Fellowship is a specialist exam- you’re going to have to study a LOT! Start early… work smart… work hard.

Study from various resources, so that you are exposed to different topics, different terminology, different ways of approaching problems, different ways of thinking about things, different points of view. Review the guidelines, read many articles, listen to different podcasts, watch useful videos. Access as many resources and methods as you can! Case discussions with your supervisor (even if they are not presented as exam questions) are hugely beneficial in gaining knowledge and understanding, as well as identifying gaps. All these will help you think through problems presented in the exams.

Step two: identify your individual learning needs. Consider your practice and experience. If you see no paediatrics in your practice, you’re not looking up the guidelines regularly, or considering different differentials, or seeing common cases and reading letters from paediatricians. You have to get all that information elsewhere. And as you will appreciate, that information cannot just be gained from reading John Murtagh’s chapters on Paediatrics and the last 3 years’ Checks and AJGP MCQ Questions. You have to do far more than that!

It’s not just about the facts, but how the facts are applied to patients in general practice, and to certain patients in particular. Again, practice this by discussing cases with your peers, supervisor and medical educators.

The exams generally test clinical reasoning – not recall. So step three is … gain an understanding of what clinical reasoning is and how it’s applied in clinical practice. And then practice it as much as you can. This can be done by looking at many many cases. Your day to day practice is a good place to find common cases. Consider wide differentials in each case and think about key features and distinguishing factors. Again, discuss them with your peers and supervisor to ensure you’ve considered all aspects and taken everything you need to into consideration. (You may want to review previous Blog posts on Clinical Reasoning and Prepare for the KFP)

Step 4… you need to review all the information you can about the exam. What is actually being tested, and how? What’s the format? There are plenty of resources available from the colleges and training organisations. Public exam report are freely available, to assist in gaining insight into the kind of questions to expect, the correct answers and the reasoning behind it. Review all the exam reports you can get your hands on to get an idea of the type of questions asked. 

What about the platform? Do you need to practice using that? Practice exams are available prior to the exam: it ensures you are familiar with the platform and format. Do the practice exam! It makes no sense not to! 

Do you need to increase your reading or typing speed (these things may well play a role in if you’re able to finish the exam). There are (….you guessed it) resources and courses available to assist with these, too!

Another important consideration is how you stay calm and think clearly in a pressured environment. This applies even to the written exams! Being able to maintain focus and concentration, and access all the information requires a calm, centred approach. For some, this comes almost naturally, but for most of us, we need to consider what happens to our thought processes when we panic. This needs to be discussed and addressed directly.

Lastly:  it’s about exam technique. This is where everything comes together.  Read what people have written about the exams – the tips. Form study groups – we’ve found that those who study together tend to do better (for various reasons).  Do some practice questions to apply everything you’ve learned. 

For successful exam completion, you’ll probably need ALL 5 steps mentioned.

Unfortunately, registrars who struggle with exams focus only on step 5 – the last one – without realising that it’s the last step of a long journey. You can’t fast forward to this step and skip all the rest, unfortunately.

It is absolutely possible to pass the Fellowship Exams if you approach them one step at a time. 

Self reflect and speak to your supervisor and Medical Educators about where they think you are at, and what you should be focussing on at this stage of your training.

Good luck!