How to study while working the NHS
Once doctors are settled in the NHS, they decide to think about giving a post graduate exam. Some find it difficult. Some may not even want to give an exam and just gain knowledge to use in their clinical work.
Either way, the principle is more or less the same which I will discuss in this blog in the form of frequently asked questions.
Frequently asked questions
ON POST GRADUATE EXAMS
I have started working in the NHS. I would like to give a post graduate exam.
My advice is to focus on your job for now. Get used to the NHS system for now. This will help you in the long run.
When should I consider giving the post graduate exam?
Give yourself at least 6 months.
Why do I need to be well settled?
So that you are not worried about anything at work and can concentrate on your exam fully.
But I think I can manage. I am about to start my first job and have booked my post graduate exam in 2 months.
Working in a new environment and giving exams can be very difficult. In the first few weeks, you come home completely drained and have no idea of what is going on. Then your on calls start in a few months which are draining as well. However after a few months you get completely used to it and do not feel tired at all.
I have worked in the NHS for around 6 months, my on calls have started and I feel pretty settled. I think I am now ready to manage.
That is great. First of all you need to sort out your leaves which I have explained here:
http://omarsguidelines.blogspot.co.uk/2017/12/all-about-leaves-in-nhs.html
How long before my exam should I sort out my leave?
It is best to sort it out at the start of your rotation. I had a 6 month long rotation so I applied for leaves in August for my MRCP 2 exam in December.
How should I start studying?
Start slowly. The more time you have, the more slowly you can start. I used to study for 30 min every day and then built up by 30 min every 3 or 4 days. Remember- study as much as you can focus on. Even if it is for 20 minutes initially.
This will take very long!
Yes, all the more reason to start as early as possible. I started a few months in advance for this reason.
This needs proper planning.
Yes, which is very easy here provided you are focused.
How should I study though with so much work?
Remember- The post graduate exam you are planning to give is related to what you are doing in hospital. For example, while preparing for MRCP and working in stroke you would have the following facts on your fingertips:
1. You do a CT head in the first instance
2. If the patient is within the window period and there is no contraindication, thrombolyse the patient.
3. Repeat CT head within 24 hours
4. If there is no bleed in repeat CT head, start on aspirin 300 mg
5. Continue aspirin 300 mg for 2 weeks and then switch to clopidogrel
6. Do 24 HR ECG, carotid doppler.
These are the most common questions asked from stroke in MRCP - with some details which you would also know if you are working in stroke medicine or even if you clerk stroke patients on your on calls.
How did you manage this?
I gave my MRCP 2 11 months into my job. I felt that I would be completely settled by then and would have seen a variety of cases on my on calls and ward jobs which would help me in my exam. Which was exactly the case! I got a few questions which I was able to answer based on my conversations with a consultant microbiologist, scans which I used to interpret before looking at the report and general management of patients.
I have explained my experience here:
http://omarsguidelines.blogspot.co.uk/2017/01/my-guideline-for-mrcp-2.html
GAINING GENERAL CLINICAL KNOWLEDGE
What if I do not want to give an exam and just want to learn things?
Work, work and work. Keep an open mind. You will eventually learn everything. Ask your parents how you learnt the alphabet. I am sure they will not tell you that you knew it by heart when you were born - you learnt it by repetition. Similarly you will learn the management of NSTEMIs, PE's, how to interpret scans because you will see so many cases on your on calls and while working on the ward.
Should I study from a book?
This is up to you. Personally I felt seeing cases on my on calls/ward work and then reading up on them in detail when I got home from up-to-date and doing BMJ e modules. Personally I find reading from books very boring.
Find what you prefer. There are books for everything. I have a huge stack of them in my house which are gathering dust.
You can also borrow books from the library - I am sure you will return them within the first few weeks without reading through them.
But see what you prefer
How do I get access to up-to-date?
I have mentioned this here:
http://omarsguidelines.blogspot.co.uk/2017/06/how-to-get-cpd-points-while-working-as.html
Overall, it is very easy to study and pass your exams while working in the NHS. It is even easier if you are working in the same specialty you intend to give your exam in.
All you need is time, planning and practice. Do not give up and do not be too hard on yourself.
Either way, the principle is more or less the same which I will discuss in this blog in the form of frequently asked questions.
Frequently asked questions
ON POST GRADUATE EXAMS
I have started working in the NHS. I would like to give a post graduate exam.
My advice is to focus on your job for now. Get used to the NHS system for now. This will help you in the long run.
When should I consider giving the post graduate exam?
Give yourself at least 6 months.
Why do I need to be well settled?
So that you are not worried about anything at work and can concentrate on your exam fully.
But I think I can manage. I am about to start my first job and have booked my post graduate exam in 2 months.
Working in a new environment and giving exams can be very difficult. In the first few weeks, you come home completely drained and have no idea of what is going on. Then your on calls start in a few months which are draining as well. However after a few months you get completely used to it and do not feel tired at all.
I have worked in the NHS for around 6 months, my on calls have started and I feel pretty settled. I think I am now ready to manage.
That is great. First of all you need to sort out your leaves which I have explained here:
http://omarsguidelines.blogspot.co.uk/2017/12/all-about-leaves-in-nhs.html
How long before my exam should I sort out my leave?
It is best to sort it out at the start of your rotation. I had a 6 month long rotation so I applied for leaves in August for my MRCP 2 exam in December.
How should I start studying?
Start slowly. The more time you have, the more slowly you can start. I used to study for 30 min every day and then built up by 30 min every 3 or 4 days. Remember- study as much as you can focus on. Even if it is for 20 minutes initially.
This will take very long!
Yes, all the more reason to start as early as possible. I started a few months in advance for this reason.
This needs proper planning.
Yes, which is very easy here provided you are focused.
How should I study though with so much work?
Remember- The post graduate exam you are planning to give is related to what you are doing in hospital. For example, while preparing for MRCP and working in stroke you would have the following facts on your fingertips:
1. You do a CT head in the first instance
2. If the patient is within the window period and there is no contraindication, thrombolyse the patient.
3. Repeat CT head within 24 hours
4. If there is no bleed in repeat CT head, start on aspirin 300 mg
5. Continue aspirin 300 mg for 2 weeks and then switch to clopidogrel
6. Do 24 HR ECG, carotid doppler.
These are the most common questions asked from stroke in MRCP - with some details which you would also know if you are working in stroke medicine or even if you clerk stroke patients on your on calls.
How did you manage this?
I gave my MRCP 2 11 months into my job. I felt that I would be completely settled by then and would have seen a variety of cases on my on calls and ward jobs which would help me in my exam. Which was exactly the case! I got a few questions which I was able to answer based on my conversations with a consultant microbiologist, scans which I used to interpret before looking at the report and general management of patients.
I have explained my experience here:
http://omarsguidelines.blogspot.co.uk/2017/01/my-guideline-for-mrcp-2.html
GAINING GENERAL CLINICAL KNOWLEDGE
What if I do not want to give an exam and just want to learn things?
Work, work and work. Keep an open mind. You will eventually learn everything. Ask your parents how you learnt the alphabet. I am sure they will not tell you that you knew it by heart when you were born - you learnt it by repetition. Similarly you will learn the management of NSTEMIs, PE's, how to interpret scans because you will see so many cases on your on calls and while working on the ward.
Should I study from a book?
This is up to you. Personally I felt seeing cases on my on calls/ward work and then reading up on them in detail when I got home from up-to-date and doing BMJ e modules. Personally I find reading from books very boring.
Find what you prefer. There are books for everything. I have a huge stack of them in my house which are gathering dust.
You can also borrow books from the library - I am sure you will return them within the first few weeks without reading through them.
But see what you prefer
How do I get access to up-to-date?
I have mentioned this here:
http://omarsguidelines.blogspot.co.uk/2017/06/how-to-get-cpd-points-while-working-as.html
Overall, it is very easy to study and pass your exams while working in the NHS. It is even easier if you are working in the same specialty you intend to give your exam in.
All you need is time, planning and practice. Do not give up and do not be too hard on yourself.
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