In the short viva scenarios, you have only 5 minutes to answer all the questions, they fly very quickly so DON’T drown yourself in the details of everything. You need to be very concise and to the point so that you reach the management part and the end of the scenario.
Trials are good to know if you have time but not essential. You will not be asked a lot of trials or their details.
You need to practise how to structure your answers in categories, for example, when you are asked about investigations , you can organise your answer as Blood investigations, radiological investigations, endoscopy etc., Another example : Complications : you can categorise them as Early versus late and then as CVS complications, respiratory complications, wound complications and so on. Another example, when you are asked to discuss consent with a patient, you can categorise your answer as , I will discuss procedure specific risks, general surgical risks, and anaesthetic risks ..etc. The idea is that if you structure your answers in categories, your answer will be clearer and will leave a good impression on the examiner.
You need to speak in the exam as a consultant who makes independent decisions based on the available facts. Show that you can have independent practice.
Your first 30-60 seconds of the station are very important, if you give a good impression from the start of the station, you will make the examiner at ease and encourage them to help you get through the station. All of what I mentioned above will help you achieve that. Also, you need to demonstrate good performance under pressure and logical thinking so that you can get your first points scored quickly.
When you are given an endoscopy image, describe what you see only, you don’t need to give a full diagnosis and say that you want to see the rest of the images and see the report.
Again, your answer should be precise, accurate and concise, you need to be slick, confident, to the point but also thoughtful and know what you are talking about. Try to make your answer flow naturally. This only comes with practice. Practice makes things flow easily as if you did it a thousand times.
Don’t speak about or bring to the discussion controversial topics. Try to be reasonable, safe, straight to the point, and don’t dig a hole for yourself. Only talk about what you know, talk about common practices and common stuff. Try to perfect the way you present your answers to convey clarity of thought and higher order thinking.
Your answer should be straight to the point, don’t faff around. If you waste time talking on irrelevant subjects, it is your time that is wasted. Remember that the examiner has a set of questions that they need to ask you in a specific time frame. The more time you waste the harder it will be to get to the end of the scenario and answer all the questions. This will affect your marks.
Latest guidelines are very important to know, these are the cornerstone of evidence that you will fall on. The examiner will ask you to provide the evidence behind your answer. Also you need to quote the evidence in your answers. For example, NICE guidelines recommend this, and so on.
Academic station is an opportunity to achieve high marks. It really is! Make sure you practise appraising papers at least once a week. Practise different types of articles e.g, RCTs, systematic reviews, cohort studies, etc. Use the latest BJS and JAMA articles. Do 2-3 papers in one session. Also record yourself presenting a paper summary and review the recording. Practice presenting the paper in no more than five minutes so that you give the examiner a chance to ask you questions.
When you answer a question, don’t say I think , you need to be sure and you need to show confidence. Also if you mention numbers or percentages, make sure these are correct and you need to know the important numbers by heart. For example risk of anastomotic leaks, etc
Practise some standard sentences that you can use quickly and subconsciously, for example, “I would systematically assess the patient according to ATLS/CCrISP guidelines while simultaneously resuscitating them” also “ My immediate concern with patient is (Diagnosis), which needs (main investigation). A good sentence to use in short vivas is “I would take a focused history of this patient’s symptoms, past medical history including performance status, drug history, family history, social history, concerns and expectations.” Then you can expand on this and say the relevant symptoms that you will ask about. Another good sentence to use with radiological images, “This is a single slice of (CT/MRI), showing – but I would like to look at the rest of the slides to assess the extent of the injury/pathology, read the report and discuss with radiology.
Don’t rush to answer the question immediately, first take a couple of deep breaths in, take 2-3 seconds first to think about the question and how you are going to structure your answer in an organised manner. Believe me, these 2-3 seconds that you take to think are crucial.
When you are asked about management or what you will do, Don’t say “you can do this” you must say I would do this or my management options are…
When you are asked about management, say what you actually do in practice in your hospital and talk about what you are familiar with. Talk about what you do. Stick to what you know only.
When you are faced with a difficult or unfamiliar scenario, take a few seconds to think and approach the scenario systematically and safely. If it is out of your expertise, say you will ask for help.
Try to use appropriate vocabulary as much as possible, also try to use professional medical terms for example, instead of saying cannula infection or central line infection you can say IV catheter related bloodstream infection and so on . Another example, instead of wound infection, you can say Surgical site infection.
