Dr Sonya Vandergoot, GPEx’s Performance Coach explains why speaking to GPs about the challenges they face in preparing for their fellowship exams can help them do things differently or more effectively in order to achieve exam success.

Becoming a GP can be both a very challenging and rewarding experience. The road to success can be difficult – Sonya’s role is one of support and guidance.

In this blog we explore:

  • the different areas of Performance Coaching such as dealing with procrastination, time management, study techniques/habits, and how to deal with exam anxiety
  • the role Performance coaching plays in exam preparation
  • the different groups of people who may seek support from a Performance Coach, and
  • GPEx courses which include performance coaching sessions.

    If you are seeking guided preparation supported by quality and reputable learning to achieve your Fellowship exam success, read on…

What is your current role at GPEx?

My primary role is as a Performance Coach, I also review literature and conduct research to enhance our programs and ensure they are evidence-based. One example is that I looked at the most empirically effective study and memory techniques to include in our courses.

What is your area of expertise and in your opinion, why the need for a psychologist?

I am an Organisational Psychologist – hence my area of expertise is psychology in the workplace. This looks at people, teams, systems and organisations, and how they work and interact together. This includes understanding motivation, self-belief, procrastination, unhelpful behaviours, stress and resilience, communication and conflict resolution, to name a few.
What I love about my role at GPEx is speaking to GPs about the challenges they face in preparing for their fellowship exams and how they can do things differently or more effectively.

What different areas of performance coaching do you focus on?

My approach is tailored to each individual but there are some common areas. For example:

  • I talk to many doctors about dealing with procrastination and managing their time more effectively leading up to exams. We discuss strategies for sustaining their motivation over time and managing feelings of being overwhelmed by the amount of information they need to cover and recall which can lead to anxiety and then, procrastination.
  • Another area I often talk about is study techniques. Many doctors tell me how they struggle to remember what they have read, especially after a long day at work. We look at the techniques they use and how to make them more effective to increase memory retention. With this, I often talk about their study habits and what a good one may look like.  The sooner good study habits can be established, the more sustainable it tends to be for the long haul. It is very much like preparing for a marathon rather than a sprint. It needs to include good self-care as well, in the form of social or family support, sleep, diet and exercise.
  • I also talk about the importance of self-care – for example, sleep is very important for learning – we store information into our long term memory overnight while we’re sleeping – good sleep equates to better learning and memory recall, whereas poor sleep – well, people will struggle to not only focus and concentrate on what their learning, but unlikely will remember it the day after – making many of their study hours a waste of time.
  • I’ll often discuss heuristics OR rules of thumb tailored to individuals’ past experiences of exams. For example, some doctors second-guess themselves during multiple-choice exams and change the option they’ve selected many times before settling on one – by that stage, they are often highly anxious and uncertain which way to go – it’s often not until after the exam that they realise that their first choice was the correct one. For them, a rule of thumb needs to be: don’t change your answer – go with your first ‘gut’ feeling. I remember talking to one doctor after her exam. She was laughing, recalling how she struggled in the exam not to change her answers and had my voice in her head saying “DO NOT CHANGE”. It worked for her and she passed!
  • Another area that is problematic for some is exam anxiety. This usually involves talking to people about their negative self-talk; being very self-critical or judgemental rather than kind and compassionate to themselves. We delve into the physical aspects of anxiety – the butterflies in the stomach; headaches or tension in the neck and shoulders and how to deal with them on the day of the exam. We also talk about different mind-sets. For example: anxiety isn’t a bad thing. It’s our bodies telling us that something (the exams / fellowship) is important to us – if we perceive it as a bad thing, we become anxious about our anxiety – and get caught in a self-perpetuating cycle of ever-increasing fear.
  • Lastly, for many doctors, sitting the RACGP or ACRRM fellowship exams may be the first time they’ve failed – this often leads to feelings of embarrassment or shame, anxiety with lots of self-doubt mixed in – it hits at their identity (about who they are, as a person and doctor) and leads to a loss of confidence. We talk through this, whether they have any unwritten rules, ‘musts or ‘shoulds’ that they live by, and how this affects their thinking, their self-expectations, and self-talk and whether these are reasonable – do they have the same expectations of others? Would they talk in that way to their colleagues or spouse?

Who are some of the different groups of people that you speak with on a regular basis?

There are many different people who seek my support and they do so for different reasons. I speak regularly to:

  • Doctors who are sitting their fellowship exams for the first time. They want to give themselves the best opportunity to pass their exams the first-time round.
  • Doctors who have failed either their MCQ, AKT or KFP exam, or maybe both, once or multiple times. They feel disheartened and have lost confidence – they need support and guidance on how to do things differently this time. We recommend you read Top 5 causes of failure in AKT/MCQ and KFP Fellowship examinations’
  • International Medical Graduates (IMG), some find these exams very different to those that they have experienced in the past or overseas; and they may have other challenges such as English as a second language, family living a long way away so they lack their support, or perhaps lack of familiarity with online exams – so they need a different approach.
  • Mature-aged Registrars who have had a career change or change in specialty late in life – they may feel a bit “rusty” regarding studying or their exam preparation.
  • Lastly, many of the doctors I speak to lead extremely busy lives – they juggle work, long hours, different jobs, relationships with partners, friends and family, young children and their care, as well as studying for these high-stake exams. It’s a lot to handle. These people may need advice or strategies on achieving a better work/life/study balance, and how to maintain their resilience in the midst of all this, given their busy schedules.

Can you share some stories and examples of people who have found the coaching valuable?

I have many stories – I would like to share 2 stories that tend to stay with me:

Sally and ‘imposter’ syndrome

One I remember is a young doctor, I’ll call Sally. She had passed the KFP Exam which is considered the harder exam, but had failed the AKT Exam. It was the first time she had EVER failed an exam. It shook her self-identity; she questioned who she was; her intellect, her career choice; as far as she was concerned, she was a failure – an ‘imposter’; it brought about a great deal of shame and embarrassment, and she couldn’t understand what had happened.

We talked through her experiences studying as a doctor so I had a better understanding of her as a person. It was clear to me that she was a very high achiever, used to achieving top grades, put in 110%, and placed very high expectations on herself. Our conversations focused on:

  • Celebrating passing KFP exam. All of her focus was on having failed – having passed one exam did not seem like a win to her so she felt she had nothing to celebrate as she thought of herself as a failure. This was her “aha” moment. The “homework”  I set her was to go out with her husband and celebrate (dinner, the works)
  • We also talked about “needing to self-care”. I made it clear that she cannot perform well if she is running on empty. For Sally, this included getting quality sleep and relaxing, which for her was running and regular exercise.
  • We also spoke about her AKT exam technique. We identified that her knowledge was very strong but her technique was problematic.  For example, she tended to select the first correct option she read and move onto the next question, without reading any of the other options. As many may know, some AKT questions have more than one correct answer option – with one more correct than others. Her tendency to not read ALL the options meant that she missed out on important marks. Related to her exam technique, was identifying “her rules of thumb”? What heuristics did she tend to use in multiple choice exams? Were these useful in this exam? this context? These rules of thumb may have been useful in her undergraduate exams, but not all of them were useful or correct in this context.

Making these seemingly small changes – which actually led to less study rather than more as the focus was on technique and self-care – lead to her passing her AKT exam

Away from home and the work/family/study balance story

Another doctor I remember working with worked in a country town a long way from home. He didn’t see his family during the week and drove home to be with them every weekend – he had to drive 3-4 hours twice a week. He felt a great deal of guilt when he wasn’t studying but he also felt resentment for not enjoying precious time with his wife and children. He was very torn so he couldn’t study effectively but also didn’t enjoy time with his family. This was affecting all aspects of his life and relationships. I recall him telling me about the time he didn’t go with them to the zoo but opted to stay home and study – a lose/lose situation or “catch 22”.

The things that made a difference for him as a result of our conversations were:

  • Changing his negative/critical self-talk
  • We also spoke a lot about the quality of his study time rather than the quantity. This was his real “aha” moment – he had an unconscious self-expectation that ALL his spare time should be spent studying– he tended to work on the principle of “All or NOTHING” so we discussed what study techniques were more effective and more efficient for him – he started listening more to podcasts as he could utilise the time on his twice-weekly drives.
  • Discussed what were his expectations or “rules”? We talked about where they had originated and if they were reasonable at this time of his life, in his context.
  • We spoke a lot about removing the guilt when spending time with family – making sure he enjoyed the time with family and friends.
  • The importance of self-care as part of exam preparation. I pointed out that he couldn’t focus or perform well if he was “running on empty” and that ‘downtime’ with family and friends was important. I needed to emphasise balance for him – and what that looked like.

He ended up delaying his exams until the next round so that he could achieve better work/family/study balance in the long term – he realised this was important to him, to his values and expectations, and he was better able to focus on study when studying, and enjoying his family when with them rather than torn between the two. Win/win.

What courses does GPEx offer where people can access your services?

There are a number of courses that include performance coaching sessions with me.