Our Experience of the Primary FRCA

Primary FRCA Exam MCQ

Sam’s experience:

In order to prepare for the MCQ, I started revision around 6 months before the exam date. Weekly time spent revising varied according to life commitments (holidays, weddings, family events etc), but was usually in the region of 12 hours. In order to try and break the content down into manageable chunks, I went through the e-LFH revision guides that are published by the RCoA and subdivided the curriculum into roughly two hour chunks, spread across two hours x3 mid-week and two hours x3 over a weekend. This had varying success; some sessions took me much less time, some took a lot longer. Also, equipment is not covered in these revision guides, which I found out later than I’d have hoped for!

I started question practice early, in the hope that I’d get a feel for the level of knowledge required as I worked through question banks. However, the existing question banks were limited for a variety of reasons. Questions of the wrong format and questions that were irrelevant caused a degree of confusion, and gave rise to the motivation to generate our questions.

Personally, I feel a mixture of book work and question practice is the way forward. Book work provides you with the ability to reason an answer from first principles, which is then invaluable when put on the spot in the SOE. Question practice complements this by highlighting gaps in knowledge, which can then direct future reading.

Jon’s experience:

I started revising for the FRCA SBA in the February before the September sitting. I felt least confident with pharmacology and so decided this was the best place to start. Several weeks later I had finished reading through Peck and Hill (now Peck and Harris) and still felt none the wiser! This is around the time that I found the e-LFH modules, and I used this to create an outline of topics to cover. I was able to cover all modules over the next 3 months, supplementing my anatomy with Graphic Anaesthesia and using Cross and Plunkett (Physics, Pharmacology and Physiology for Anaesthetists) to cross reference many concepts. Rather than dedicating a set amount of time to revision each week, I aimed to complete a set number of modules to keep on track. Finishing a ‘first pass’ by early/mid June meant I had plenty of time to re-review topics.

This is around the time I started completing questions from available FRCA question banks. I found this extremely useful to signpost me to key concepts and topics within each domain, as well as highlighting material that I had never seen before. I was completing my ITU block at the time, and this meant I was often with other trainees sitting the exam and so we would often discuss questions together. I probably started doing 10-20 questions each day and ramped this up to about 100 in the weeks immediately before the Primary MCQ.

The SOE

Sam’s experience:

I sat the MCQ in September, and my reward for success was to sit the SOE/OSCE in November. Some choose to go later, or to space them out further, but I was inclined to prepare for the SBA with enough understanding of the content that my SOE preparation was focussed more on exam technique than acquiring additional knowledge.

I practiced with Jon 2-3 times a week, starting in July, covering 2-3 topics at a time. We used FRCA Reveal as our resource for providing SOE questions, which we could chat about immediately after by revealing the answers.

Due to the manner in which I prepared for the SBA, the level of understanding required for the SOE was already there. I think if I’d focussed too much on purely practising questions without a level of understanding, I’d have struggled to get ready for the SOE in time. This is why we reference each question against a relevant textbook/article/guideline, to allow the user to broaden their understanding going forwards.

Jon’s experience:

Similarly to Sam, I sat the FRCA primary MCQ in September and proceeded straight into preparing for the OSCE/viva (hoping that I had passed the MCQ). The MCQ is often called the knowledge exam, and the viva the technique exam, although I felt that right up until the point of sitting the OSCE/viva I was still finding and learning new content.

The Masterpass books present concepts in a manner that lend itself well to viva work, and I found that these together with the FRCA reveal app provided a good base for this exam. Sam and I practiced with one another once or twice a week, and I found that keeping this regular practice was invaluable alongside my other work. FRCA reveal allows you to practice independently. I spoke my answers out loud to myself, and really focussed on structure (‘classify or die’).

My opinion is that it is still important to refresh knowledge over this period, and I was certainly grateful for this, as several more obscure topics formed a large part of both my pharmacology and physics exam.

The OSCE

Sam’s experience:

The OSCE is easy to neglect, but still poses a significant challenge. During my sitting and sittings immediately after, the pass mark for the OSCE was remarkably close to the mean score, which reflects the challenge this exam can pose.

Preparation for the OSCE included attendance at a mock OSCE (Barnsley), a recap of ‘exam mode’ clinical exams, and review of resuscitation/anaesthetic emergency guidelines. I practised history taking, again using FRCA reveal, to obtain an understanding of how to score highly.

On the day there were multiple stations which were challenging, but by scoring highly on the predictable stations (history, examination, communication, resuscitation, simulation) I was able to compensate and pass.