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A Candidate's Advice for FRCS Orthopaedic Exams
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A Candidate's Advice for FRCS Orthopaedic Exams
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Language: EN.
Segment:0 .
Much so, I kindly went on the course organized by the orthopedic Research UK for assessments prior to the exam, which I found very useful, so recognize some of the faculty from that and thank you.
So I thought I'd go through a bit of just generic about how the exam set up at the moment, obviously with a lot of changes. So apologies if there's any repetition or people have heard this already, but there will be no patients at the next exam. Again, it's due to be held in Glasgow. Scenarios with patients are replaced by iPad images with either pictures or videos which will be displayed on the patients, which is obviously particularly important in the long and short cases where you normally have a patient examination.
On arrival, you're provided with a surgical mask, which is which you're expected to wear through the entirety of your time within the example. And if by myself you're a bit nervous, for example, you find yourself twitching with a surgical mask at times or wondering if people have understood what you've said through a surgical mask, so it is a different experience. And then with regards to actually how the short and long cases I've noted had changed was you're expected to be able to discuss the examination maneuvers.
Firstly, how you do them. And then secondly, and most importantly, they were quite interested in how specific examination maneuvers worked, such as Allen tests or Nelson's test. So you have to be prepared to revise all of the examination maneuvers, essentially in order to explain both how you would do them and how they work. What exactly it is you're looking for, which is something which you can be a relatively unfamiliar experience.
As you know, it's not something we often do in our day to day practice. So then moving on to the actual sort of my basic science experience within the exam, the scenarios commence either with an iPad image or a brief scenario that's described and it's not going to be a straight, you know, go to a certain topic like cartilage, for example. I think the examiners are all aware that everyone is likely read that, read the topics there's a clinical lead in.
And so my talk just sort of covers trying to. Presuming guess the way the scenario is going to work in order to maximize the amount that you can get out within the five minutes. And that's the technique that Mr Nawaz sat down with me and it does work very well because five minutes is limited time and it's about getting out the important information in that period. So for example, if you have an image of a TKR with a sinus, you're aware that it's a basic science station and it's likely to lead on to something about infection, antibiotic mechanism of action.
Or, for example, you may have a station or where you told the surgeon has a high infection rate. Again, it's a basic science station, so likely that may be to do with infection control within theater or theater design. So moving on to my cases, this, for example. Sorry to interrupt. Could you just put it on presenter mode, please? Sure presenter mode that.
Sorry so, no, sorry about that. So if you provide it, for example, with this image and told that it's a relatively young patient, it's obviously a lateral radiograph, a slightly mature patient with significant degenerative changes, which you wouldn't expect in someone of a young age group.
Therefore, you're thinking that the patient has an underlying disease process, such as rheumatoid arthritis. So directions that this station could go into are either talking about the pathological processes and basic science behind rheumatoid itself, or it can go into the elbow stability. So if it were to follow an elbow stability type pattern within the basic science station, you'd be expected to discuss the primary and secondary stabilizers to the elbow.
If you're a particularly good draw, you could draw the triangle, which you have in the next slide of the anterior bundle of the medial collateral ligament. The lateral ulnar collateral ligament and the ulnar humoral articulation form in the primary stabilizes and with the secondary stabilizers, the radio-ulnar articulation and the common flexion extension or origins.
If you're not particularly good at drawing and speaking at the same time, like myself, I personally wouldn't draw things unless you're specifically asked to. And if you are specifically asked if it's quite clear because I have this with the scenarios where you were specifically asked to draw layers of a specific zone. Then after being asked about the anatomical stabilizers of the elbow, it's clear that this patient has end stage rheumatoid disease and the treatment options would be a total elbow to elbow arthroplasty.
So we're all aware that the indications for TPA within rheumatoid disease patients show the longest survivorship and the key things here from a basic science principle perspective are that the prosthesis you would use is a sloppy hinge. So this is a various balance constraint linked prosthesis. You'd be expected to justify why you're using a sloppy hinge type prosthesis, and that again goes back to your Triangle of the stabilizers of the elbow.
Because your ligamentous structures can't be trusted, a more constrained type of prosthesis would be used. And again, moving on. Finally, you might be asked why you would not use a fully constrained type of prosthesis. And that's because the evidence has shown due to the pressure put on the bone cement interface, there's early, loose, early loosening of such prostheses. So again, this works from just identifying the picture in front of you and just thinking ahead as to where the station could go so that you don't waste time within your five minutes.
So following another example would be if you are asked to investigate symptoms of carpal tunnel syndrome, if the location of the nerve compression wasn't clear again, as a basic science station, you know that this isn't about examination maneuvers or being asked how to test different nerve distributions. So the station is working around nerve conduction studies. And once you've moved on to the meat of the question, you would be expected to describe how a nerve conduction study works.
I think this image is always classically used and is the sort of thing I have mentally in my head if I had to describe it. It shows a stimulating electrode. There's a recording electrode on the thenar eminence. There's also a reference electrode on the thinner eminence, and there is a ground election, a ground electrode further distally on the patient. As this stimulating electrode is placed proximal and the recording electrodes are placed distal.
We know that a oculomotor nerve is being tested and vice versa. If the stimulating electrode was placed distal and they're recording electrode placed proximal sensory nerve was being recorded. Again, of the images I found during the revision time, I think this is one of the best to just think of it in your head. If you asked to explain a nerve conduction study and then moving on from that, you would be expected to go through a basic graph shows if you access, you have the voltage on the X-axis of the time, you'd be expected to explain the amplitude, which is the time from onset.
So which is the overall increase in the peak from the baseline and the latency, which is the time from onset of the stimulus to the up peak that can be seen here? If the station was progressing well, the could be asked within milliseconds whether you thought that the conduction or whether the latency time appeared to be normal. And again with a nerve conduction study.
What's not present on the graph is the conduction velocity, and you may be asked how you would calculate this, which again is easy to reference from the previous diagram that it's relating to the distance between the stimulating electrode and the recording electrode gives you the distance, and the latency gives you the time, so distance over time will give you the velocity again. Example the reason why I brought this on up as clinical base sciences just working from it won't simply be describing nerve conduction study, and we'll move on in a pattern, such as this.
A final example that I have is a patient cyclically immature. There's evidence of previous metalwork in situ from previous obviously bilateral femoral fractures as evidence of a new intra capsular neck of femur fracture. It's not normal to be expecting a patient of in the young age group and therefore you be expected to discuss possible underlying diagnoses, such as a metabolic bone disorder or osteogenesis imperfecta.
In this scenario, if it went down the line of osteogenesis imperfecta, you'd be asked to explain exactly what that is, which is a disorder either of a quantitative or qualitative nature of type 1 collagen. And again, I wouldn't offer up anything or say anything that you're not willing to either justify or explain. For example, if you were to bring up the silence classification, you will be expected to explain it.
So if you don't know a classification, for example, it's best not to mention it. And again, I would say there's always a tendency in exam to fill what you think are silences with things that just come out of your mouth. And it's a very useful thing to just take a step back once you've described it and wait for the examiner to give you the next question from the mark sheet. Because if you jump in as people often do and I'm sure I did at least a few times and say something a bit silly or stupid, you will spend 60 seconds of your five minutes justifying what you've said or trying to go back on something you've said simply to fill up, fill a timepiece.
So given that this is a osteogenesis imperfecta station, how it would progress. It could be the talk about collagen and the structure of collagen to this may include drawing it, for example, or it may go onto the biomechanical principles and difficulties faced on a basic science level of fracture fixation in an osteogenesis imperfecta patients. So these would include residual limb deformity from previous fractures, having to plan and anticipate the fact that the patient may have fractures in the future and also wanting to avoid any stress rises in, particularly from previous metalwork in situ.
So I hope this has been useful to show three cases that progress onto a basic science topic from either a clinical question or a clinical photograph. Because perhaps if I had spent more time in my basic science win in a group setting trying these types of approaches, I think the questions are much more realistic than having a partner or group member simply ask you, what's the structure of what's the structure of bone, for example?
And then just to go on, you know, the breadth of stations includes anything from dire Fermi to cartilage to compartment syndrome, so there is quite a breadth and from everything that I took from my peers who sat the exam. There were no unfair core topics within the basic science station. It was just about ensuring that your technique is adequate to get out what you undoubtedly have learned in the five minutes and feel like you've really been able to show what you've learned within the five minutes to the examiner.
I understand that a few mistakes were required, is that the case? But usually we thank you for preparing them. Go ahead. So first one on the screen, I don't know if we can reply via message. Well, why don't we just run through the questions, because we didn't get a chance to set up the poll?
Let's do it now. Um, probably not. It takes a place of time to get them up. OK if you are running through them, it's really good, sir. So again, these are more sort of part one sort of typical questions that you may get. So again, sort of looking at osteogenesis imperfecta, what's the mutation or gene responsible for this? And you'll often be provided with a number of answers that aren't correct and it'll often come down to which you think it is.
No, people can't respond at the moment. Or can they via the chat? Yeah so D which people have responded, which is the correct answer? And then the next one again. So based on my talk, which type of implant for total elbow arthroplasty is most commonly used in rheumatoid arthritis? Yeah Mohammed, with the semi constrained type of prosthesis.
And finally. With regards to nerve conduction studies, is latency, the time from the baseline to negative peak is at the time from the onset of the stimulus to onset of the response. Does it show the muscle itself and the innovation as the needle is inserted or is it measured in meters per second?
Again, Mohammed mazzoli with BTC, the time from the onset of stimulus to onset of the response. I don't know if there's any questions about the general format that if anyone wanted me to answer. Joe, was there any questions? I didn't see anything. Sorry, no further questions in the chat box.
Anyone wants to ask a question. It's just about the format of the exam. Or yeah, I actually I want to ask you a question. You mentioned that as a group, you used to practice asking each other questions in the way that they'd be asking the exam. How valuable do you think that is? I think that just I think studying, I think that's invaluable.
I actually don't think that you can revise on your own if I'm. Well, I think it would be very difficult to. I revised with two other candidates and we covered different topics, asked each other questions. I think it's very difficult to replicate that experience of actually speaking aloud so much, particularly about things like basic science, which we often don't talk about in day-to-day practice. And also, I think the thing that is most key in your group is to stick to the 5 minutes and not be polite about letting your colleague run on.
Because actually, on the exam day, the most important thing is you have that specific five minutes in which to answer the question and get through the mark scheme to get to your six, seven or eight. And if you're spending long periods on one part of a question or you haven't listened to the question, for example, particularly in the trauma stations, when you're told, I was told on five of six stations that it was an isolated injury, the examiner doesn't want to hear the Atlas jargon, for example, for 60 seconds.
That's a very good point. Actually listening to the questions also an important part of answering the question. The when you were with your friends, where they mean to you or where they actually think you have to make an agreement that if someone particularly says something that isn't correct or isn't factually right, that they need to be corrected one for their own understanding, it's not doing them any help.
And also, if you are learning in a group, it is dangerous. If you don't correct people who say wrong things because it's very easy for that to go into your brain. I think it's when you revise probably more distant from the exam, there's leeway to be, you know, to allow for the fact you just started to revise. But in the run up in particular, we just had random questions because everything was sort of fair game.
And I have to say the vyver practice in particular that consultants like Mr Lescano did in their own time was probably some of the most useful revision that you could do and flex out a six or seven hour revision day, one hour of a practice with a consultant. Our topic was far more valuable, often in the run up, because if you pass the part one, you have the factual knowledge. It's more just about having that technique in order to pass the part to perfect thank you.
The question from how does it compare to past one and how do other bullets compare the way so? So I'd say ortho bullets was one of the main things I use. I use the author bullets and I've done the youkai every year. I think the ortho bullets are easier because there's often one clear answer. And if you pay for the premium subscription, this does lead to some slightly more difficult questions.
It certainly covers the topic areas and provides the explanations for the questions. But I think the real difference is and not to be shocked when you go in which I was warned about beforehand. This or tablets, often there'll be one clear answer in the exam. It's often down to between two answers. Three are clearly incorrect and I think in the building of the mix, they're specifically designed like that.
That three, for example, will be shown to be immediately implausible and then down to the last two, it requires a certain level of higher order thinking and reading. The question stems such as it may say, a relative contraindication or an absolute contraindication, for example, and looking at that phrasing. So I think also bullets was invaluable to my revision process for the part one.
But I would say the structure of the questions in the actual exam is slightly more difficult and slightly more clinically orientated to the UK sort of exam setting and its testing. Have you learned enough in the sort of UK training experience? You said how many sessions per week would you recommend that you do so again? We all have jobs and, you know, everyone's coming home and it is difficult. I found the easiest thing to do personally was two or three sessions a week.
And again, it's about having a committed group you want to be revising with people who are equally as committed to the exam. And I personally think they need to be doing the same exam sitting as you because that fear has to be there that two or three weeks before when you're doing those sessions. If you we broke the syllabus down into a 9 week plan allowing for two weeks of random vyver at the end.
So a week paid a week of trauma, a week of hands, for example, and then broke down the sort of core topics within that. So that you were sort of covering key areas within that provided the two weeks before to do sort of random topics or consultant based sessions. I think the consultant based sessions are the most valuable and most important in that sort of the short run up to the exam when you have the most knowledge that you can probably going to have.
And you just need those final tips and tricks from a consultant in that field about how to answer specific questions. But I think, yeah, two to three was the most logistically where we could arrange your nine week number came from the fact that it was nine weeks between. Yeah yes, there was nine weeks left. And then the other topics had to go into 9 weeks, unfortunately. Perfect but of course, your grand juries, you're not.
Apologies are under the process for studying for exam is six months. My experience with most guys who are doing it. Oh, I would say I was a lucky individual that I sat the lockdown exams, the ones that didn't get canceled. I started advising in mid-September for an exam that was completed in early mid-june. So if anything, I spent months, slightly more and I didn't have any distractions in lockdown of revising of anything open.
So I was quite lucky when I did it. But it is a commitment process and particularly for anyone who's looking to get a group. I think the key is that the other candidates are sitting it when you are because you need people who are just as committed to that sitting as you, particularly when you're practicing coming home at 8 o'clock in the evening. Because if someone you're working with hasn't prepared their questions or done, they're reading.
It makes the session a lot less useful than it should be. And I was lucky that the other two group members that I or three group members I revised with were equally committed and it made an excellent learning environment. Thank you very much. All right.
Segment:0 .
Much so, I kindly went on the course organized by the orthopedic Research UK for assessments prior to the exam, which I found very useful, so recognize some of the faculty from that and thank you.
So I thought I'd go through a bit of just generic about how the exam set up at the moment, obviously with a lot of changes. So apologies if there's any repetition or people have heard this already, but there will be no patients at the next exam. Again, it's due to be held in Glasgow. Scenarios with patients are replaced by iPad images with either pictures or videos which will be displayed on the patients, which is obviously particularly important in the long and short cases where you normally have a patient examination.
On arrival, you're provided with a surgical mask, which is which you're expected to wear through the entirety of your time within the example. And if by myself you're a bit nervous, for example, you find yourself twitching with a surgical mask at times or wondering if people have understood what you've said through a surgical mask, so it is a different experience. And then with regards to actually how the short and long cases I've noted had changed was you're expected to be able to discuss the examination maneuvers.
Firstly, how you do them. And then secondly, and most importantly, they were quite interested in how specific examination maneuvers worked, such as Allen tests or Nelson's test. So you have to be prepared to revise all of the examination maneuvers, essentially in order to explain both how you would do them and how they work. What exactly it is you're looking for, which is something which you can be a relatively unfamiliar experience.
As you know, it's not something we often do in our day to day practice. So then moving on to the actual sort of my basic science experience within the exam, the scenarios commence either with an iPad image or a brief scenario that's described and it's not going to be a straight, you know, go to a certain topic like cartilage, for example. I think the examiners are all aware that everyone is likely read that, read the topics there's a clinical lead in.
And so my talk just sort of covers trying to. Presuming guess the way the scenario is going to work in order to maximize the amount that you can get out within the five minutes. And that's the technique that Mr Nawaz sat down with me and it does work very well because five minutes is limited time and it's about getting out the important information in that period. So for example, if you have an image of a TKR with a sinus, you're aware that it's a basic science station and it's likely to lead on to something about infection, antibiotic mechanism of action.
Or, for example, you may have a station or where you told the surgeon has a high infection rate. Again, it's a basic science station, so likely that may be to do with infection control within theater or theater design. So moving on to my cases, this, for example. Sorry to interrupt. Could you just put it on presenter mode, please? Sure presenter mode that.
Sorry so, no, sorry about that. So if you provide it, for example, with this image and told that it's a relatively young patient, it's obviously a lateral radiograph, a slightly mature patient with significant degenerative changes, which you wouldn't expect in someone of a young age group.
Therefore, you're thinking that the patient has an underlying disease process, such as rheumatoid arthritis. So directions that this station could go into are either talking about the pathological processes and basic science behind rheumatoid itself, or it can go into the elbow stability. So if it were to follow an elbow stability type pattern within the basic science station, you'd be expected to discuss the primary and secondary stabilizers to the elbow.
If you're a particularly good draw, you could draw the triangle, which you have in the next slide of the anterior bundle of the medial collateral ligament. The lateral ulnar collateral ligament and the ulnar humoral articulation form in the primary stabilizes and with the secondary stabilizers, the radio-ulnar articulation and the common flexion extension or origins.
If you're not particularly good at drawing and speaking at the same time, like myself, I personally wouldn't draw things unless you're specifically asked to. And if you are specifically asked if it's quite clear because I have this with the scenarios where you were specifically asked to draw layers of a specific zone. Then after being asked about the anatomical stabilizers of the elbow, it's clear that this patient has end stage rheumatoid disease and the treatment options would be a total elbow to elbow arthroplasty.
So we're all aware that the indications for TPA within rheumatoid disease patients show the longest survivorship and the key things here from a basic science principle perspective are that the prosthesis you would use is a sloppy hinge. So this is a various balance constraint linked prosthesis. You'd be expected to justify why you're using a sloppy hinge type prosthesis, and that again goes back to your Triangle of the stabilizers of the elbow.
Because your ligamentous structures can't be trusted, a more constrained type of prosthesis would be used. And again, moving on. Finally, you might be asked why you would not use a fully constrained type of prosthesis. And that's because the evidence has shown due to the pressure put on the bone cement interface, there's early, loose, early loosening of such prostheses. So again, this works from just identifying the picture in front of you and just thinking ahead as to where the station could go so that you don't waste time within your five minutes.
So following another example would be if you are asked to investigate symptoms of carpal tunnel syndrome, if the location of the nerve compression wasn't clear again, as a basic science station, you know that this isn't about examination maneuvers or being asked how to test different nerve distributions. So the station is working around nerve conduction studies. And once you've moved on to the meat of the question, you would be expected to describe how a nerve conduction study works.
I think this image is always classically used and is the sort of thing I have mentally in my head if I had to describe it. It shows a stimulating electrode. There's a recording electrode on the thenar eminence. There's also a reference electrode on the thinner eminence, and there is a ground election, a ground electrode further distally on the patient. As this stimulating electrode is placed proximal and the recording electrodes are placed distal.
We know that a oculomotor nerve is being tested and vice versa. If the stimulating electrode was placed distal and they're recording electrode placed proximal sensory nerve was being recorded. Again, of the images I found during the revision time, I think this is one of the best to just think of it in your head. If you asked to explain a nerve conduction study and then moving on from that, you would be expected to go through a basic graph shows if you access, you have the voltage on the X-axis of the time, you'd be expected to explain the amplitude, which is the time from onset.
So which is the overall increase in the peak from the baseline and the latency, which is the time from onset of the stimulus to the up peak that can be seen here? If the station was progressing well, the could be asked within milliseconds whether you thought that the conduction or whether the latency time appeared to be normal. And again with a nerve conduction study.
What's not present on the graph is the conduction velocity, and you may be asked how you would calculate this, which again is easy to reference from the previous diagram that it's relating to the distance between the stimulating electrode and the recording electrode gives you the distance, and the latency gives you the time, so distance over time will give you the velocity again. Example the reason why I brought this on up as clinical base sciences just working from it won't simply be describing nerve conduction study, and we'll move on in a pattern, such as this.
A final example that I have is a patient cyclically immature. There's evidence of previous metalwork in situ from previous obviously bilateral femoral fractures as evidence of a new intra capsular neck of femur fracture. It's not normal to be expecting a patient of in the young age group and therefore you be expected to discuss possible underlying diagnoses, such as a metabolic bone disorder or osteogenesis imperfecta.
In this scenario, if it went down the line of osteogenesis imperfecta, you'd be asked to explain exactly what that is, which is a disorder either of a quantitative or qualitative nature of type 1 collagen. And again, I wouldn't offer up anything or say anything that you're not willing to either justify or explain. For example, if you were to bring up the silence classification, you will be expected to explain it.
So if you don't know a classification, for example, it's best not to mention it. And again, I would say there's always a tendency in exam to fill what you think are silences with things that just come out of your mouth. And it's a very useful thing to just take a step back once you've described it and wait for the examiner to give you the next question from the mark sheet. Because if you jump in as people often do and I'm sure I did at least a few times and say something a bit silly or stupid, you will spend 60 seconds of your five minutes justifying what you've said or trying to go back on something you've said simply to fill up, fill a timepiece.
So given that this is a osteogenesis imperfecta station, how it would progress. It could be the talk about collagen and the structure of collagen to this may include drawing it, for example, or it may go onto the biomechanical principles and difficulties faced on a basic science level of fracture fixation in an osteogenesis imperfecta patients. So these would include residual limb deformity from previous fractures, having to plan and anticipate the fact that the patient may have fractures in the future and also wanting to avoid any stress rises in, particularly from previous metalwork in situ.
So I hope this has been useful to show three cases that progress onto a basic science topic from either a clinical question or a clinical photograph. Because perhaps if I had spent more time in my basic science win in a group setting trying these types of approaches, I think the questions are much more realistic than having a partner or group member simply ask you, what's the structure of what's the structure of bone, for example?
And then just to go on, you know, the breadth of stations includes anything from dire Fermi to cartilage to compartment syndrome, so there is quite a breadth and from everything that I took from my peers who sat the exam. There were no unfair core topics within the basic science station. It was just about ensuring that your technique is adequate to get out what you undoubtedly have learned in the five minutes and feel like you've really been able to show what you've learned within the five minutes to the examiner.
I understand that a few mistakes were required, is that the case? But usually we thank you for preparing them. Go ahead. So first one on the screen, I don't know if we can reply via message. Well, why don't we just run through the questions, because we didn't get a chance to set up the poll?
Let's do it now. Um, probably not. It takes a place of time to get them up. OK if you are running through them, it's really good, sir. So again, these are more sort of part one sort of typical questions that you may get. So again, sort of looking at osteogenesis imperfecta, what's the mutation or gene responsible for this? And you'll often be provided with a number of answers that aren't correct and it'll often come down to which you think it is.
No, people can't respond at the moment. Or can they via the chat? Yeah so D which people have responded, which is the correct answer? And then the next one again. So based on my talk, which type of implant for total elbow arthroplasty is most commonly used in rheumatoid arthritis? Yeah Mohammed, with the semi constrained type of prosthesis.
And finally. With regards to nerve conduction studies, is latency, the time from the baseline to negative peak is at the time from the onset of the stimulus to onset of the response. Does it show the muscle itself and the innovation as the needle is inserted or is it measured in meters per second?
Again, Mohammed mazzoli with BTC, the time from the onset of stimulus to onset of the response. I don't know if there's any questions about the general format that if anyone wanted me to answer. Joe, was there any questions? I didn't see anything. Sorry, no further questions in the chat box.
Anyone wants to ask a question. It's just about the format of the exam. Or yeah, I actually I want to ask you a question. You mentioned that as a group, you used to practice asking each other questions in the way that they'd be asking the exam. How valuable do you think that is? I think that just I think studying, I think that's invaluable.
I actually don't think that you can revise on your own if I'm. Well, I think it would be very difficult to. I revised with two other candidates and we covered different topics, asked each other questions. I think it's very difficult to replicate that experience of actually speaking aloud so much, particularly about things like basic science, which we often don't talk about in day-to-day practice. And also, I think the thing that is most key in your group is to stick to the 5 minutes and not be polite about letting your colleague run on.
Because actually, on the exam day, the most important thing is you have that specific five minutes in which to answer the question and get through the mark scheme to get to your six, seven or eight. And if you're spending long periods on one part of a question or you haven't listened to the question, for example, particularly in the trauma stations, when you're told, I was told on five of six stations that it was an isolated injury, the examiner doesn't want to hear the Atlas jargon, for example, for 60 seconds.
That's a very good point. Actually listening to the questions also an important part of answering the question. The when you were with your friends, where they mean to you or where they actually think you have to make an agreement that if someone particularly says something that isn't correct or isn't factually right, that they need to be corrected one for their own understanding, it's not doing them any help.
And also, if you are learning in a group, it is dangerous. If you don't correct people who say wrong things because it's very easy for that to go into your brain. I think it's when you revise probably more distant from the exam, there's leeway to be, you know, to allow for the fact you just started to revise. But in the run up in particular, we just had random questions because everything was sort of fair game.
And I have to say the vyver practice in particular that consultants like Mr Lescano did in their own time was probably some of the most useful revision that you could do and flex out a six or seven hour revision day, one hour of a practice with a consultant. Our topic was far more valuable, often in the run up, because if you pass the part one, you have the factual knowledge. It's more just about having that technique in order to pass the part to perfect thank you.
The question from how does it compare to past one and how do other bullets compare the way so? So I'd say ortho bullets was one of the main things I use. I use the author bullets and I've done the youkai every year. I think the ortho bullets are easier because there's often one clear answer. And if you pay for the premium subscription, this does lead to some slightly more difficult questions.
It certainly covers the topic areas and provides the explanations for the questions. But I think the real difference is and not to be shocked when you go in which I was warned about beforehand. This or tablets, often there'll be one clear answer in the exam. It's often down to between two answers. Three are clearly incorrect and I think in the building of the mix, they're specifically designed like that.
That three, for example, will be shown to be immediately implausible and then down to the last two, it requires a certain level of higher order thinking and reading. The question stems such as it may say, a relative contraindication or an absolute contraindication, for example, and looking at that phrasing. So I think also bullets was invaluable to my revision process for the part one.
But I would say the structure of the questions in the actual exam is slightly more difficult and slightly more clinically orientated to the UK sort of exam setting and its testing. Have you learned enough in the sort of UK training experience? You said how many sessions per week would you recommend that you do so again? We all have jobs and, you know, everyone's coming home and it is difficult. I found the easiest thing to do personally was two or three sessions a week.
And again, it's about having a committed group you want to be revising with people who are equally as committed to the exam. And I personally think they need to be doing the same exam sitting as you because that fear has to be there that two or three weeks before when you're doing those sessions. If you we broke the syllabus down into a 9 week plan allowing for two weeks of random vyver at the end.
So a week paid a week of trauma, a week of hands, for example, and then broke down the sort of core topics within that. So that you were sort of covering key areas within that provided the two weeks before to do sort of random topics or consultant based sessions. I think the consultant based sessions are the most valuable and most important in that sort of the short run up to the exam when you have the most knowledge that you can probably going to have.
And you just need those final tips and tricks from a consultant in that field about how to answer specific questions. But I think, yeah, two to three was the most logistically where we could arrange your nine week number came from the fact that it was nine weeks between. Yeah yes, there was nine weeks left. And then the other topics had to go into 9 weeks, unfortunately. Perfect but of course, your grand juries, you're not.
Apologies are under the process for studying for exam is six months. My experience with most guys who are doing it. Oh, I would say I was a lucky individual that I sat the lockdown exams, the ones that didn't get canceled. I started advising in mid-September for an exam that was completed in early mid-june. So if anything, I spent months, slightly more and I didn't have any distractions in lockdown of revising of anything open.
So I was quite lucky when I did it. But it is a commitment process and particularly for anyone who's looking to get a group. I think the key is that the other candidates are sitting it when you are because you need people who are just as committed to that sitting as you, particularly when you're practicing coming home at 8 o'clock in the evening. Because if someone you're working with hasn't prepared their questions or done, they're reading.
It makes the session a lot less useful than it should be. And I was lucky that the other two group members that I or three group members I revised with were equally committed and it made an excellent learning environment. Thank you very much. All right.
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