Advice

Mindset

• Option A: I am willing to wholly commit 10-12 months of my life to study and position myself to pass the exam even on a bad day.

• Option B: I will study for 10-12 months but only wholly commit in the final 3-6 months and hope to pass the exam.

• Option C: I do not plan to wholly commit to 10-12 months of study and will see if I am able to still pass the exam.

Coverage phase

The goal of the coverage phase is to cover the entire curriculum. From my MAK95, I took from 14 September 2024 to 19 April 2025 to complete the coverage phase. I've attached my MAK95 schedule below. There are two approaches — the LO method or the SAQ method. I did a hybrid LO-SAQ method. I started with an LO and saw what SAQs were linked to that specific LO. I then wrote notes for the LO and ensured that my notes also covered all the relevant information for the linked SAQs. For LOs that did not have a linked SAQ, I would see if the CICM primary exam had a past SAQ on the LO and use their examiner reports to help create a structure. The goal for my notes was to write down only what I would eventually seek to memorise or what I required to understand the topic. I did not aim to write excessive notes that I would never memorise. The notes also had to be structured — this was key. My LO notes were written in structures so that, ideally, when I went to make my model SAQ responses I could essentially "copy-paste" my LO notes. You will see that my notes became better at achieving this as I moved through the curriculum. I barely read textbooks — I relied heavily on other people's notes (mainly the resources I have mentioned in About). The only textbook I read back-to-front was Lachlan Rathie's textbook. I found that other people have already written incredible notes, but it was my job to synthesise these notes into memorisable structures. So I would read one set of notes, synthesise those notes into my own structure, then crosscheck those notes with at least one other resource (e.g. another set of notes, examiner reports, podcasts etc.). If I didn't understand a certain topic, I would then consider looking at a textbook or seeking other resources (e.g. YouTube). After writing notes for an LO, I would move on to the next LO until the complete subtopic (e.g. "Respiratory") was finished. After every 5-10 LOs, I would create handwritten flashcards that synthesised my computer-based notes into concise cards. This would become my working memory. There are some examples of my flashcards below and by the end of the coverage phase I had approximately 900 flashcards made. If you do make flashcards, I highly recommend NOT waiting until revision phase to do this — you will never get to them. Do them as you go. Handwritten flashcards > ANKI, in my opinion. After writing flashcards for 5-10 LOs, I would also write out from memory on a scrap piece of A4 paper all of what I've retained from those LOs. This was how I tried to practice active learning. The scrap pieces of paper were just scribbles that I never looked at again, but I tried to do it all from memory to see if I actually understood the content I had just made notes for. I would then make model SAQ responses for the given subtopic SAQs. The majority of the time this just involved "copy-pasting" my notes since my LO-based notes were designed to have answered the relevant SAQs. During the coverage phase, I did not participate in any regular study group. This was not intentional and my morale may have benefitted from one, but I only found an effective study group in the revision phase. The best advice that I received in the coverage phase is that learning actually only starts in the revision phase — i.e. the coverage phase is to ensure you understand the content so that when you see that content again in the revision phase it is much easier to grasp and memorise.

Revision phase

I had 17 weeks and 2 days of revision phase. At the start of the revision phase, I did not think I was going to pass — I could not remember the large majority of the curriculum. However, my revision phase was long, intentionally, and my coverage phase demonstrated that I actually understood the content and all I needed to focus on was re-learning it and memorising it. My goals in the revision phase were to (1) memorise the content (2) regurgitate the content via SAQs and (3) do MCQs. To do (1), my aim was to cycle through my notes as many times as possible before the written exam by reviewing my ~900 flashcards. In the first run through, I would aim to go through ~10 flashcards per day on work days and ~50 flash cards per day on days off. I would then lag doing the relevant SAQs a few days after I had gone through the flashcards, to provide an opportunity for active learning. This included all past SAQs back to 1999 on MAK95. I relied heavily on typing SAQs on my computer rather than handwriting SAQs — I found it much more efficient. The first run through of the curriculum took approximately ~6-7 weeks, the second run through ~3 weeks, the third run through ~2 weeks, and the fourth run through ~1 week which was done in the week prior to the exam. Each run through became quicker and quicker. After the third run through, I felt confident that I had memorised the majority of the curriculum. It was after the first run through of the curriculum when I started with my study group. The key purpose of study group was (1) accountability and (2) morale. We started to meet x1 times per week, then x3 times, then at peak revision phase (last two months) x4-6 per week. Initially we generated ten random SAQs from MAK95 and would complete them to time via typing on computer, giving ourselves five minutes per question. In five minutes, I would be able to type an entire SAQ response on my computer. We would then discuss them briefly as a study group and the following day I would review my typed responses and compare them to my model SAQs. Closer to the exam, we started to do Lachlan Rathie's The Primary Exam Companion SAQ sets (x13) — these sets we did handwritten and to time. A few times, we also generated 30 SAQs from MAK95 and in 60 minutes typed out structures to all SAQs — this allowed for great breadth of content coverage however reviewing the 30 SAQs afterward took a long time. Study group then became my accountability to practice SAQs, while my own study time was for cycling through my flashcards. I only completed a total of two handwritten practice exams (15 SAQs) prior to the written exam — this was more than enough to prove to myself that my hand had adequate stamina for 2.5 hours of writing. I also started MCQs in late May after my first run through of the curriculum — this involved reviewing past MCQ banks and ANKI decks. I did not do any MCQs prior to the revision phase. In the last two weeks before the exam, in addition to doing a final run through all my flashcards, I read through all my model responses to SAQs on MAK95 back to 1999 and I also reviewed the past five years of CICM SAQs that had crossover with the ANZCA curriculum. The day before the written, I reviewed the more difficult SAQs and then did spot testing on random topics to keep my memory fresh.

Written exam day

The written examination has changed so that the SAQ component is first in the day and the MCQ component later in the day. I welcomed this change. The day is stressful, mainly the SAQ component, and generally you think less clearly under that degree of stress. I found time management much more difficult in the actual SAQ exam compared to my practice SAQ exams. In practice exams, my approach was to prioritise the SAQs that I found "easiest" first in order to "gain" time, i.e. complete these SAQs in <10 minutes, so that I would have more time to spend on more difficult SAQs. This meant I often found myself having an extra 10 minutes at the end of the practice exam to review my responses. However, in the actual SAQ exam, despite applying this approach, I was not able to "gain" time. This was because, recognising this was the real exam, I wanted to write more legibly and write more detail for the given SAQ — and hence I found myself having to stop writing every 10 minutes to move on. This made the exam more stressful and I felt that I wasn't completing many SAQs to the best of my ability. The more prepared you are for the exam, the more challenging this will be because the more knowledge you need to prioritise. The key in the SAQ exam is that you need to be able to regurgitate content quickly — you do not have time to "think". On the other hand, I found the MCQ exam less stressful. I was able to finish the MCQs in 75 minutes and used the remainder of the time to double check all my answers and ensure that I had shaded in the correct box. 

Viva phase

After the written examination, I mostly rested for 1 week though I did have some concerns that I would start forgetting content. My goals in the viva phase were to (1) continue cycling through my flashcards to keep the curriculum fresh and (2) doing as many practice vivas as I could. I found many trainees relied only on practice vivas to revise the curriculum, which inevitably leads to forgetting content. I aimed to receive x4 five minute vivas from consultants or past trainees per day — some days I was able to achieve this whereas other days there was no one free to viva with me. With my study group, we aimed to meet x3-5 times per week to do four practice vivas as well. We gave each other vivas that we had received from other consultants or vivas that we ourselves had made up. During this time, I also received practice viva documents and I tried to go through these, simply by reading them, to increase my exposure to vivas. The viva phase showed me that I had significant gaps in my knowledge — content that I had not learned pre-written exam. Almost every viva would have questions that I could not answer and I would try to document these gaps so that I could revise them closer to the real viva. I found the viva phase less intense than the coverage and revision phase. This is because you either did or did not know the answer to the question and the examiners could help by prompting you if you had forgotten to say an important piece of information. The best advice I received for vivas is to learn to speak fast — it is a time-based exam and the more questions you can get through the more possible marks you can receive.

Viva exam day

The exam took place at the W hotel in Brisbane, Australia. I flew to Brisbane the day before. My viva was the first session on the first day. After completing registration, we waited in a conference room. The Chair of the Primary Exam gave a short talk emphasising that our performance on the day did not reflect our self-worth. We were then taken by invigilators into the main hall and, in pre-determined groups of three, lined up next to our viva stations. My viva topics included MAC, local anaesthetics, temperature, fasting, suxamethonium, control of ventilation, cardiac action potentials, benzodiazepine pharmacodynamics, blood groups, neuromuscular monitoring, renal blood flow, and opioid bolus kinetics. I found that the majority of the examiners were helpful in allowing me to progress through the viva. My suspicion is that examiners are more likely to guide the candidate who appears prepared and is able to demonstrate understanding. After the viva, we were sequestered for a few hours — then bliss.