Getting through your finals

Dr Martha Martin graduated from King’s College London this year and is now working as an FY1 doctor at Homerton University Hospital in East London. She offers this year’s cohort of final year medical students her top revision tips for those all-important exams.

Welcome to final year! The year when the jigsaw pieces of the human body fit together and the ultimate reward of finally being able to call yourself “doctor” is realised.

Here are my suggestions for getting off to a good start, with tips and resources to help make your final year manageable and even enjoyable. This is your last year wearing the student badge – so make the most of it!

Work out how you work best

Even though you have been studying for five or six years, if you are like me you may find that every year it feels as if you have forgotten how to revise. Sitting down at the beginning of the year and reflecting back on what has worked for you in the past is essential.

For example, I realised quite late in the day that I am a very visual learner. Unless I can see everything coded in brightly coloured pens I struggle to absorb the information in front of me. Mind maps act as a skeleton for the topics I need to cover while flash cards provide the meat.

I created colour-coded schemes to cover; definition, pathophysiology, epidemiology, signs and symptoms, management/treatment, and ‘not to forget’ points. I then consolidated this by doing past questions.

In contrast many of my friends wrote barely anything down and instead trawled through the hundreds of questions you can find online or in question books.

The resources hunt

Another thing to get sorted out before you start revising is knowing what you need to cover. For this I recommend you visit your university course website or contact your course administrators to obtain your course syllabus. Not only will this outline what you need to cover but you will get a sense of the level of detail required.

After that it is up to you to choose your tools. The Oxford Handbook is the chosen substance for many medical students while others go for Mini Kumar and Clarke. Alternatively there is an infamous set of notes by an Imperial medic that have circulated up and down the country – if you can get your hands on them.

Once you have chosen one of the three resources above, supplement your knowledge from more detailed and up-to-date sources like BMJ Best Practice, GP Notebook, and NICE CKS.

Test yourself with questions from websites like Pass Medicine (my favourite), BMJ On Examination and Pastest after you have revised each topic. Soon you will be walking in the steps of thousands of medical students who have successfully passed their finals – as impossible as that may seem right now.

The exams

This final year is intense because the extent of knowledge to cover is limitless. The crucial point is not to expect yourself to learn everything. Instead final year is the time to get know the common clinical cases in each organ system well. Your examiners want to make you ready for your job as an FY1, not as a consultant.

Knowing the management of anaphylaxis (one of the few scenarios in exams where you need to know the dose of a drug) and the first line treatment for someone with hypertension is much more useful than knowing the antibody which occurs in people with Sjorgren’s disease. If you happen to remember that antibody, that’s brilliant. But if not, don't worry. There will be a good few questions covering the niche knowledge that you have subconsciously accumulated.

The key here is not to feel overwhelmed but to break your revision into sections and chunks. The different organ systems are the perfect sections by which to organise your revision. Creating sub-sections or smaller topics underneath an overarching topic will really clarify what you need to go through.

Draw out a revision timetable as soon as you can, map out what you will do each day and leave a good week of leeway - things always take longer than you think. Once you have got your resources together you should be rolling and crossing sub-sections off lists becomes the highlight of your day!

The OSCE

This is the part that people dread the most but I can reassure you that it is not as bad as you think. In fact, on the day the adrenaline rush means that before you know it the whole thing is over and all you will feel is freedom coursing through your veins.

The key with the OSCE is to practise as soon as possible! Find OSCE groups and organise an afternoon or evening of practice once or twice a week. I recommend being part of more than one group so that you practise with a broad range of people to learn from as many different styles and situations as possible.

I found that the people who do best in the OSCEs are those who ‘play the game’. Each station has a formula which you should have gone through so many times by the actual OSCE that whatever curve ball they throw at you (which I’m afraid they do) you can catch it and manage your response with a deep breath and an empathetic statement.

Again, it’s important to know what your specific medical school expects of you. Find your online curricula and speak to people in the years above. Often (very often) stations that have come up in previous years are repeated and many different student-created OSCE guides circulate. The best bet is to use one that is specific to your medical school. The MasterPass Easy Guide to OSCEs books are very useful in having everything in one place. And remember, you are not expected to be able to do anything more than the level of an FY1 doctor.

Talk it out

This is a tip I wish I had learnt earlier in my medical career. Talking through stuff with your medical colleagues is one of the most effective ways of actively learning. While sitting on your own in the library trawling through hundreds of pages of notes is essential, mixing it up with a bit of group work will make all the difference.

Start by making a plan of the topics you want to cover in each session. Things take longer to get through than you think so be realistic about how much you can cover and how long you can work effectively. Make sure you have some lovely food and snacks to keep you going, bring out the whiteboard and then spend your session firing questions at each other.

Verbalising your knowledge will identify where you have gaps and also surprise you as to what you know already.

Some people choose to work in groups with friends while others do better to identify people with whom they have worked well on placement. You might even make new friends – some of the people I am planning to keep in touch with after medical school are those I met through revision.

In summary, this is a hard year - in terms of length for some medical schools and short intensity for others. However the key thing is to remember that you can do it. Work hard, only entertain the levels of stress which make you productive and most importantly continue to do the things that make you feel good like running, seeing friends and family and eating good food. Before you know it summer arrives and FY1 is a whole other chapter!