I was an Examiner for the FRACGP for a number of years and have noticed that the candidates that did not do so well in the exam had a number of pointers...
  • They did not have the right mindset.  They approach the exam with the mindset of a "Candidate" instead of being "the Doctor".  Remember, a lot of it is role playing so you have to be "in the role".  It is part of the "game" unfortunately.  One of our previous candidate who attended our exam workshop said to me with a sense of surprise, "How come it is a bit like drama school".  My answer was, "In some respect....YES!".  So on the day, dress up the way that you would dress up for work and make sure you "put your Doctor's hat" on.  Remember that the people in front of you on the day are patients and NOT Examiners albeit sometimes, they are "difficult patients".  Remind yourself that it is going to be easier than your usual day at work as you will probably see less number of patients and each one of them is going to finish on time! (which most of us will rarely experience in our working lives).
  • They did not stay in the role and get caught up in the technicality of the exam format.  They lost their "flow" and hence, getting "blanks" in their thought process.  Remember to "play along" with the game. 
  • They were generally not strong on counselling skills, so I would encourage candidates to work on this further eg reflective skills, summarizing, validating, emphathizing etc....
  • They were not confident in dealing with mental health issues.  As you would all be quite well aware, mental health eg Depression and Anxiety are very prevalent in this country and hence, the FRACGP Exam reflects this.  It is important for you to be confident in recognizing, assessing, diagnosing and treating mental health issues.  How to deal with suicide risk is very very important.  Asking at risk people for suicidal thoughts and active plans of self harm is extremely important.  I cannot stress enough this point.  Ask your supervisor to help you further on these skills if you are not confident in this area.
  • They were not prepared.  The format of the exam is not a "true reflection" of real life consults and hence, you will need to get very familiar with the format and be comfortable with it.  There is no easier way to do this.  I would recommend for people to get into groups of 3 and practice, practice and more practice.  One person as the patient, one as the examiner, and the other one as the observer.  Take turns in being in different roles so you can have an appreciation of the whole exam concept.
  • They did not use their 3minutes pre-readings well.  Remember, to read the question.  If it is a joint examination, then make sure that this is the main thing you do.  You will not generally get marks for taking a history if the station is about doing the examination.  Also, pick up on clues in the pre-readings.  You should have some idea about the differentials or problem list in this pre-reading.  For example, if they give you a case of a 40yo with headaches, you should be able to put down as your differentials tension headaches, migraines, sinusitis, meningitis, viral, and the more "rare stuff" like temporal arteritis and even tumour.  By thinking of your problem list, you will able to direct your questioning towards confirming or excluding your differentials.
  • They were not able to keep their nerves at bay.  Again, being prepared, having the right mindset, a positive and confident attitude, and having a good night sleep before exams will help towards alleviating this problem.
Throughout this blog, I will be posting a number of cases and invite a general discussion as how to approach the cases.  I will also post a number of posts and videos to share ideas around mental health so that you can become more confident in dealing with mental health issues.

In the meantime, if you have any suggestions or questions, please feel free to comment on this blog in the comment section.  You can also subscribe to the blog for updates.

Thank you for visiting out site.

Dr Vinh Tran
MBBS FRACGP University of Qld
Supervisor for GP trainees for GPTQ and Medical Students at Griffith, Bond and UQ
Accredited TripleP Provider