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Learn by my mistakes ­ and triumph in the oral

Blind panic and verbal diarrhoea

are not the best techniques for getting through the MRCGP oral, writes Dr Prashini Naidoo

here are 16 candidates in the Long Room upstairs. A lady in a twin-set with pearls herds eight of us to one half of the room and the rest to the other side. I'm acutely aware of the small space between the propped up screens separating the candidates. After the introductions, the nightmare begins.

'What are the stages of burnout?' My mind goes blank. My heart starts to pound; my eyes dart nervously to the hardened faces of the examiners; the hum of the room fades, and I am aware of a silence that rolls like a giant wave from me towards 'Hatchet-face One' and 'Hatchet-face Two'.

A ray of inspiration strikes a terrified neuron, a connection is made; memory feeds to tongue and out pours a gush of verbal diarrhoea.

'Do you have any thoughts on patient safety?' I have lots of them, going off like a warehouse of Chinese firecrackers in the recesses of my brain. I have never spoken this fast in my life.

Out of the room we troop. We gather around at the water table to wet our lips and prepare for round two with different examiners: 'Baldie' and 'Twinkle-eyes'.

Feeling a bit more confident, I beam inanely. I have obviously watched too many Miss World contests and speeches of world peace stir in my bosom.

Suddenly Baldie pounces with: 'What do you do if your practice nurse is consistently late?' This has me stumped. I stumble about blindly.

My irritation at Baldie begins to rise. I want to reach across and brutally pluck the few wispy hairs carefully combed across his shiny pate. Surely this is a grossly unfair question. Surely his technique of asking is completely wrong.

Eventually we get to the point. 'What is your opinion of staff appraisals?' Alas, it is too late. I'm outraged by the injustice of it all. I could have waxed lyrical if he'd asked properly. I feel like crying.

Eventually, the gong sounds. We are released into the cold, uncomforting air of Hyde Park.

What I learnt on reflection

My oral exam was a hideous experience, despite my exhaustive preparations. On reflection, there were many lessons to be learned from my mistakes. Here are a few.

 · The atmosphere in the common room can be a strain. If you arrive early, go for a walk or read a novel while you wait.

 · Most candidates take their exams upstairs on the first floor. The tables are surprisingly close together and when you first walk in, you are acutely aware of neighbouring candidates. It is important to concentrate really hard on listening to the first question and to shut out the background noise. If you don't

hear the first question, ask the examiner to repeat it. Most people settle down once the first question is out of the way. If you remain distracted, don't panic; take a few calming breaths and start again. It is better to lose a few minutes rather than destroy your composure for the rest of the exam.

 · The questions get harder and most people will be asked something for which they are not prepared. Go back to basic principles; look at the argument from all sides, and make a considered decision, as you would in real life. Not every question can be answered with quotations from the BMJ and reference to ethical principles.

 · There will be the occasional disgruntled, sharp-tongued examiner who will raise your hackles. It is dangerous to let your emotions take over. Give calm and considered answers and ignore the emotional baiting.

 · It is important to think rapidly about the theme the question is pursuing and to get the gist quickly. While it is important to pursue the ideas, concerns and expectations of the tardy practice nurse, it is equally important to show the examiners you have a working knowledge of management principles and employment law.

 · Preparation for the oral exam involves reading and practice; answering a few questions out loud in the company of colleagues is far less embarrassing than floundering in front of the examiners.

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