Have you started preparing for your Fellowship exams such as the RACGP AKT/KFP/CCE, ACRRM MCQ or another medical specialty? Many people put their lives on hold until they sit these important exams – and though it can be a challenge, it is usually time well spent. All will agree that they only want to have to do these exams once.

All exam preparation guides and experts will tell you that it’s important to plan effectively for exam success. The ‘ideal’ way to prepare for your exams is to:

  • Identify your knowledge gaps.
  • Develop SMART goals according to your identified knowledge gaps. Smart goals are those which are specific, measurable, achievable, relevant and time-bound.
  • Develop a study plan – one that includes: what, why, where, when & how. An effective study plan will keep you on track. Ensure you also include time for self-care (e.g. exercise, relaxation, socialising, and sleep), which is an often under-estimated component of effective exam preparation.
  • Develop a weekly study routine – regular ‘appointments’ with yourself to form a study habit to manage busy times or periods of low motivation.
  • Join a study group or find a study partner. Study groups are great sources of motivation and commitment.
  • Implement your study plan with regular reviews to stay on track and identify new study goals.
  • Leave the last 2 – 3 weeks to revise your study notes and prioritise self-care (this is not the time to start covering new material).

But what about those of you who feel that time studying doesn’t feel like time well spent? Have you ever felt like your study session has been unproductive, wasteful, or that you just aren’t making any progress? It is easy to feel like a square peg in a round hole when you hear your colleagues are studying hard and you are struggling. Many will devise the perfect plan but struggle to implement it. Others will feel disconnected from the process of studying, finding themselves staring at the page or the same sentence. Many will feel they did a lot of work but nothing ‘sunk’ in.

It may be something you’ve always struggled with; studying may not come ‘naturally’ or easily for you. Whatever the reason, if you are struggling to prepare for your Fellowship exams, now is the time to act.

Reflect and ask yourself the following questions:

Am I using my preferred learning style?

There are three main learning styles: visual, auditory, and kinaesthetic (seeing, hearing and doing). We tend to have a preference for one of these. Hence if your preference is kinetic but you’re using visual techniques, it will make studying more challenging for you (but not impossible). Using your preferred learning style is an effective study technique. It’s like being right-handed; although you can write or do things with your left hand, it feels awkward or may take you longer. The same is true of using study techniques congruent with your preferred learning style – they are likely to be easier, which means information will be more efficiently processed. Many people have one dominant preferred style, while others may have a combination of two. Examples of visual learning methods include use of notes, lists, checklists, mind-maps, or drawings. Auditory learners prefer to hear information through storytelling, listening to recordings, teaching or conversations. Lastly, kinaesthetic learners tend to find it difficult to sit still for long and can be easily distracted when learning. So, they prefer to learn by doing and thinking, such as making models, practising, recalling while moving around or reciting while counting on their fingers. They also like to learn through context (with patients). To discover your learning style, you can complete a VAK self-assessment questionnaire here.

Am I bored?

When studying for long periods of time, it’s easy to get distracted and feel bored. Ironically, you’re not doing your memory retention any favours. Research shows that our memory benefits from regular, consistent, short study sessions, rather than long but infrequent sessions (e.g. daily one-hour sessions five times per week is preferable to a five-hour study session once per week). Short frequent study sessions reduces memory decay between study sessions, ensuring more information goes into your long-term memory over time. This also assists the recall of information from your long-term memory when needed. In addition, information goes into your long-term memory best when you are fresh and alert. Short study sessions with regular breaks are more beneficial, because you are unlikely to become fatigued and loose concentration and will better absorb the material you are learning. Research also suggests that morning study sessions (before lunch) tend to be better than afternoon study sessions (more alert and focused in the morning).

Is my self-talk about studying negative or critical?

When you find yourself thinking negatively, it is good to stop and take a deep breath. Recognise what is happening and name how you are feeling (e.g. OK, I am feeling anxious/stressed/tired and my thinking is reflecting how I am feeling). Challenge your thinking and ask yourself: What’s the evidence for this? Are there any other alternative views? Is this likely? What are the chances that this is true? Is this true ALL of the time? How much does this really matter…today…tomorrow or next year? Would I expect the same of others? Check if you have unrealistically high expectations of yourself or if you equate your performance with your self-worth. Get out of your head and reconnect with your body and surroundings – notice what you can see, hear, feel, touch, taste and smell (e.g. by noticing the feel of the chair you are sitting on, the floor beneath your feet or listening to the birds chirping outside). Re-engage with what you were doing by giving your full attention to the task at hand.

Am I procrastinating?

Procrastination has been defined as voluntarily delaying an intended course of action despite expecting to be worse off for having done so. Putting off important tasks often results in feelings of guilt and loss of motivation. It can also lead to stress and anxiety as a result of not meeting deadlines. The good news is…procrastination is not a character flaw! It is a learned maladaptive behaviour which usually has a root cause or trigger, such as fear of failure or feeling overwhelmed on how to proceed. Does that sound like you? Understanding your trigger(s) for procrastination can help you address why you are avoiding exam preparation and be the first step towards regaining control.

Is there a disconnect between what I’m learning and my work?

Try reinforcing what you have learned in a study session (e.g. an article or guideline you’ve read) through taking notes, writing lists, drawing flowcharts, diagrams or mind-maps, or through discussions with patients, colleagues or friends. This ‘engagement’ with what you are learning helps ‘hook’ the information in your long-term memory to these various situations, patients, or conversations, making it easier to recall the information in stressful situations such as an exam. For example, learning in novel environments such as by the beach can assist you to remember the information you learnt by recalling the beach. It also works with sound, taste and smell (e.g. listen to a particular song when learning key points of an immunisation schedule to be able to recall it later by thinking of that song). Additionally, reinforcing what you are learning through your work with patients assists you to contextualise your memories, making them easier to recall when needed.

Do I feel isolated in my studies?

While some prefer to study alone, others can find studying alone to be very isolating and lonely. Everyone is different. If you are finding it isolating, don’t continue to struggle alone. Find a study group or partner to study with – this is a great strategy to maintain motivation, problem-solve and bounce ideas off each other, as well as to keep perspective and maintain positivity. It can emphasise how much you know, as well as identify what you don’t know. Often study groups are a great source of information, resources and tips. If procrastination is also an issue for you, then a study group or study partner is even more important, as they aid motivation and commitment to learning – after all, it’s harder to cancel a scheduled time or let others down than not keeping an ’appointment’ with yourself. It’s also easier to become negative and anxious when studying in isolation, leading to further procrastination and avoidance.

Am I neglecting myself?

Self-care is an often neglected and underestimated aspect of exam preparation. For example, over a century of research has established that quality sleep benefits memory retention. In their review of sleep and memory research, Rasch and Born (2013) highlight the active role sleep plays in memory consolidation, with short-term memories ‘saved’ into our long-term memory overnight. This is when newly-encoded memories are consolidated into our long-term memory store. If you don’t sleep, you won’t retain what you learnt that day!! Exercise is equally important for memory retention by increasing synaptogenesis, which supports learning and makes it easier to absorb information and form long-term memories. Other important self-care strategies include eating a healthy diet, maintaining social connections, using resilience and stress management techniques and maintaining a positive mindset. Remember to keep a positive stress perspective (i.e. stress is normal versus stress is bad) and reflect on any previous failures with self-compassion and present-focused goals (what can I do differently this time?).

Do I feel like an imposter?

Imposter Syndrome has been described as a tendency for people to persistently believe they are incapable or intellectually inadequate, even when faced with evidence to the contrary. Imposter Syndrome involves feeling:

  • Like a phony, fraud or fake;
  • In danger of being exposed or discovered as a fraud; and/or
  • That awards, praise or recognition for good work or achievements are undeserved.

When feeling this way, question your self-talk (where is the evidence?) and remember what you do well. Ask for feedback on your performance. Talk to others about your feelings – you’ll likely be surprised how many high-achievers feel the same way. And remember – no one is perfect.

Where to start

It’s important not to confuse simple with easy – just because its sounds simple, it won’t necessarily be easy to do. Start by choosing one or two steps that will help point you in the right direction for exam success. Don’t underestimate each of the small steps you make to improve your exam preparation, as each journey starts with that first step.

Remember – there’s nothing you can do about yesterday, you can only change today.

Feature Image: Jernej Furman