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How to pass the Fellowship MCQ Exam. That’s the question on everyones lips as we head towards the pointy end of studying for the exam.

If you have never sat this exam before, let me tell you, the ACEM Fellowship exam, is a long day, so be rested. 3 hours of SAQ exam and 3 hours of MCQ/EMQ exam. You need to be able to think.

Here is some simple exam strategy for the MCQ. This is revision for all the Fellowship Exam Course candidates, but important to remember.

  1. There are no tricks. The examiners don’t try to purposefully trick you into picking the wrong answer. This set of questions is to test your knowledge. But really it is a bit of a trick, as the very nature of having distractors, obstacles to steer you away from the correct answer, is a trick. But that’s playing within the rules. There is no other overt trickery, no Machiavellian plot to deceive you all…..just some of you.
  2. Gone are those things that irritated us, as well as those hints that helped us all get a few more answers right, purely by technique:
    1. Those beautiful words ‘ALWAYS’ and ‘NEVER’, that made us exclude an answer…..gone!
    2. “All are correct EXCEPT” and the irritating, ‘pick the INCORRECT answer”, which were always confusing…. gone forever!
    3. The Double Negative… Vanquished!
    4. The LONG response full of qualifying adjectives, which was almost always the correct answer…it is also gone!
    5. The grammatical clues, where distractors just seemed to flow from the stem…gone!
    6. The verbal associations, where like words in both the question and answer usually meant it was right…wiped out!
    7. ‘None of the Above’ or ‘All of the Above’…..never to be seen again!
  3. Every word in the Question(stem) is there for a reason, so READ EVERY WORD. There is a process by which these questions are written. They are shaped and re-shaped, to make them less vague and more appropriate, so that that they don’t disadvantage you.
  4. Once you have read the question STOP and think of potential answers to this for 10-20 seconds. It is imperative that you do this, so that you are not swayed by what is in the distractors.
  5. Then read the distractors(answers) and eliminate those that are wrong.
    1. The sort of things that will lead you to the wrong answer include, choosing a distractor that has familiar terms in it. Although this may be in fact right, it may also be wrong. Scrutinise the whole answer.
    2. Beware the answer that is partly right. For example you may have a question that says: “You have just seen a 46 yo female patient patient with a previous history of hyperthyroidism, that now presents with symptoms and signs that you believe are those of thyroid storm. Some of the findings you would expect wound be”:… and one of you answers may be “A widening of the pulse pressure due to hormone relate vasoconstriction”. You know that the first part of this answer is correct, the pulse pressure widens, however the second part of the answer is incorrect.
  6. DO NOT change your answer unless you have had an epiphany. Your first answer is usually the right one.
  7. There is no negative marking so if you are not sure, guess. This is not so bad, given that in most cases we tend to get down to two answers. Your real chance is then 50%.
    1. Devise your own system i.e., mark D for every one you don’t know
      1. As much as I hate to say it, A is usually not the right answer
    2. Have a random way of choosing i.e., dice with only 1-4 corresponding to a – d taken into consideration.
    3. My favourite, choose (b) or (c)- you can choose one and then the other alternatively.


One final word on how to prepare….Do a lot of MCQ’s and study around them i.e., study the topic area. Even more importantly, write MCQ’s, as this gets you into the examiner’s head.

Create a ‘Hard Facts’ File, where you keep the facts you need to have for the exam.

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