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This is for those Emergency Medicine registrars about to sit the ACEM Written Fellowship Exam.

It’s 4 weeks to go until the Exam….

That’s right it’s 4 weeks and bit to go until the Fellowship Written. It’s about now, that the doubts and fears set in.

“I’m not ready”. “I’ll never get it” ” I know nothing!”

How do you get control of those fears and anxieties? There is a great method that I’ve used and it comes from a book called The Artist’s Way. It’s basically a way to empty all the stuff going around in your monkey brain. To get it out of there so you can function.

How do you do it you ask? It’s very simple. After you’ve gotten up and had a cup of coffee, sit down with a journal or a ruled pad and write two A4 pages. Just dump everything you’re thinking about. Don’t worry about it being, a good piece of writing, just get it out of your head and onto the paper. Write everything you’ve been thinking about, dreaming about and that’s worrying you. Get it all out. It lets you really stop the overwhelm of messages rattling around in your head. You must write TWO A4 pages.

I’ve done this, for some time now and it’s effect is incredible. I initially heard about it from a very clever man, Tim Ferriss. Try it and you will see how your thinking is freed up.

What to do with 4 weeks to go

This is a direct excerpt from the Fellowship Exam website. For all the members on the site login and go to the syllabus page and scroll to the bottom, there you will see my top 15 predictions.

For non-members, you won’t be able to see the list and the 15 predictions, however the approach of easing up as you go into the exam is reproduced here.

In the countdown leading up to the exam, this would be my preparation approach. You will have your own approach and that’s fine, because you prepare in your own way. As long as you look at the list below and make sure you have reviewed these topics, it doesn’t matter. Here is a suggested approach:

4 WEEKS TO GO: Put a massive week plus a day or two into filling as many gaps as possible, concentrate on the big ticket items from your revision.

3 WEEKS TO GO: Look at the top 64 topics listed and ensure that these are part of the topics you have studied and have summaries of, as they seem to come up quite regularly. You need to have a list of the big ticket items. I call this my 3 month list. If I were to only study for the exam for 3 months, what would I study for greatest yield? This is the 80/20 Principle. More like 70/30 here.

2 WEEKS TO GO: Go over the top 15 I have included on fellowship and make sure that you know these. Now I can’t guarantee they will come up, but I will say that quite a few on my list do.

THE WEEK BEFORE THE EXAM: Go over your notes and think about how a question might be phrased. Think of drug dosages(but don’t memorise endless infusion rates etc). Look at the admin questions and remember the general approach to all admin that we have taught etc…

Should I sit the exam?

Why is this a difficult question? Because of the limited numbers of attempts allowed. That is a greater stressor, than failing, because your brain goes into a future that doesn’t exist yet and creates an outcome that may not occur, but could and with that causes doubt and fear.

‘I am an old man and have known a great many troubles, but most of them never happened.’
                                                                                                    Mark Twain

Here are my thoughts:

  • If you fail the written exam the first time, it could just be bad luck, if you fail a second time, it’s a knowledge issue, hands down. Don’t sit until you are ready.
  • Answer the question “Should I sit?” by being honest with yourself.
  • If you honestly believe that you are prepared and I don’t mean know everything…..because you can’t, but you feel confident that your knowledge is good enough to get you a good score….and it’s your first time….. sit.
    • What does being prepared mean?
      • It means that if I asked you a question right now, you wouldn’t embarrass yourself.
      • It means that you have strategy for answering- the strategy we teach.
  • Why do I say sit?
    • Because you can be well prepared and fail.
    • You will never be perfectly prepared
    • You can know a lot of stuff and have a horrible set of questions come up
    • The things you can’t control will be the things that will get in your way
    • Because the experience of the exam itself, in terms of showing you just how well you have to be prepared and what a pure marathon effort is needed, will be invaluable to you. If you pass..fantastic. If you don’t and you were fooling yourself…….you will know. It will help you for the next attempt.

Good Luck

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