Study Tips for GP Registrars

I have had several requests from general practice (GP) registrars in the last few months, asking about exam study advice, including the million-dollar question, “what do I need to focus my study on?!”  I am by no means an expert on study techniques, however having recently achieved Fellowship of the Royal Australian College of General Practitioners (RACGP) I thought I could offer some insights into approaches to study that I have found useful over the past few years.  Other very useful posts on GP exam preparation to take a look at are Dr. Penny Wilson’s “Exam Tips for Trainees”, and Dr. Genevieve Yates’ “RACGP OSCE Exam Tips”. I would also like to point out that being a rural GP registrar does not mean that you should be professionally isolated from your peers, especially with access to technology and social media including Skype, Dropbox, Twitter and Facebook.

1. Join or form a study group

  • Collaboration and support from peers is key
  • Keep each other accountable
  • I suggest limiting study group numbers to about 5 registrars per group

2. Have a plan of action, and allow enough time to prepare before the exams

“FAQ: What might they ask about in the exams?

Answer: ANYTHING and everything!  It’s GENERAL practice!”

My study group (well, initially Dr. Gerry Considine from ruralflyingdoc.com – thanks Gerry!) put together a spreadsheet for the 6-7 months leading up to exams to make sure that we were confident that we’d covered the most common and important areas in general practice.  Each week, 1 or 2 people covered that area by producing a summary document and posting links/references of their sources of information to a Dropbox folder shared by the group.  Meanwhile, everyone else did thier own personal study knowing what was coming up by the end of the week.

Our study group was made up of 5 registrars who were based in different locations across rural South Australia, so we chose to meet over Skype, which worked really well for us.  During our study group sessions, after our initial catch-up and debriefing time, the person who prepared the summary for that week presented their information and answered any questions from the group.

Now that exams are over, we all miss our weekly catch-ups, even though it was for study!

3. Look at BEACH data and ICD data and learn the common things well, for example:

  • Hypertension
  • Immunisations
  • Check-ups (preventive health)
  • Upper respiratory tract infections
  • Depression & anxiety
  • Arthritis
  • Diabetes
  • Lipid disorders
  • Back complaints/musculoskeletal complaints
  • Oesophageal disease
  • Asthma & COAD
  • Urinary tract infections
  • Dermatitis/eczema/psoriasis
  • Gastroenteritis
  • Skin cancer
  • Atrial fibrillation
  • Ischaemic heart disease
  • Contraception
  • Osteoporosis
  • Osteoarthritis

3. Find a way to meet regularly

  • If at a distance, find a medium which works for your group, e.g. Skype or an online webinar platform
  • Be willing to be flexible with times/days, for example, if someone is on-call

4. Work out the time you are most focused to set aside time for personal study

  • For me this was often the first hour or two in the morning
  • Don’t be afraid to study for only 20-30 minutes at a time – every little bit helps!
  • Use positive reinforcement for yourself by allowing small rewards for periods of study
  • Have a break for 10 minutes for every 50 minutes of study time
  • Have a clean & clear study space so that you can focus; I am a brilliant procrastinator and mostly do so by cleaning – so I try to pre-empt this when I am planning to study by ensuring my study space is ALREADY clean!

5. Utilise several different resource types (in no particular order)

  • GPRA website for exam resources and webinars – by the General Practice Registrars Association in Australia
  • Therapeutic Guidelines
  • National Prescribing Service
  • Australian Prescriber
  • RACGP Check program– this was fantastic preparation, particularly for the Key Feature Problem (KFP) exam
  • Text books, including Murtagh’s “General Practice”, and Susan Wearne’s “Clinical Cases for General Practice Exams”
  • UpToDate
  • Online journals

6. Study in order to be a good GP, not just to pass exams

The reason we have examinations is to demonstrate that we have the knowledge and skills to be safe, competent GPs.  It feels great to know the answer to a patient’s question, or to be able to diagnose and treat a patient’s condition, especially if it is rare or serious – we will always be learning and hopefully always bettering ourselves with study and research even after exams are done and dusted.

Use your day-to-day GP work as prompts for study, for instance, look things up as you come across them, and ensure that you take a history and perform an examination as though you are being examined, so that you are already doing OSCE practice during work time.  Past exam papers are helpful to get used to question styles, but are not the be-all and end-all and were certainly not what I focused on in my study time.

7. Use work time as study time

Make good use of tutorials and ask your supervisor to observe your consults so that you can receive feedback on things that you do well, and things that could be improved; video consults are also a very useful way to improve your consultation skills, although they can be quite confronting!

Remeber that simply working in general practice everyday will be preparing you for the exams – the college exams are not developed to try to trip you up, but rather to ensure that you will be a safe and competent general practitioner.

8. Enrol for exams!

As I sat the Royal Australian College of General Practitioners (RACGP) exams, I know most about their processes.  You will need to be a financial member of the RACGP in order to enrol (and to access their educational resources).  Go to the RACGP website to find out about enrolment dates and details.  You will need to enrol at least 2 months in advance and there are two exam cycles per year.  The Australian College of Rural and Remote Medicine (ACRRM) has different processes and exams, so if you are an ACRRM registrar you will need to check the ACRMM website for more details.

My awesome study group at one of our rare face-to-face meetings

My awesome study group at one of our rare face-to-face meetings

If you are currently preparing for your GP exams, I know that you will feel that inevitable apprehension, stress and worry, but having gone through that and emerged out the other side, I can say with all honesty that if you prepare with enough time and if you are working in general practice during this, you will more than likely be fine.  Then you can look back on this time, like me, with nostalgia!

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8 thoughts on “Study Tips for GP Registrars

  1. Nice one Mel – and I know you re too modest to say, but readers should be aware that you scooped the prize for RACGP exams for SA in 2013

    OK, two questions :

    (i) use of FOAMed?

    the EM/CC trainees are using this more and more…but one needs to be cautious with trotting out ‘some crazy shit from twitter’.

    would you recommend FOAMed resources for learning? If so, which?

    (ii) ACRRM

    I was lucky enough to get grandfathered into ACRRM kind-of, with Fellowship based on previous experience and meeting some requirements. They’ve toughened up the exam a bit since,.,,probably a good thing, as my taking a video of wiping my bum with FRACGP certificate didnt go down well with some College luminaries

    Is it possible to still get BOTH qualifications, or do you have to do one or other? For my mind, FACRRM still the better qualification for rural practice….but noone wants to jump through extra hoops or do two Fellowships just for fun (and they are both pricey!). Thoughts>

    • Thanks Tim!

      To answer your questions:

      (i) use of FOAMed

      As most of us now know, FOAMed stands for “free open access medical education”. #FOAM is a commonly used hashtag on Twitter to link people to good online medical education resources. There is also a more recent acronym/hashtag called FOAM4GP which is more targeted toward GP type presentations. I would encourage GP registrars to get involved with FOAMed, whether it is as a learner, or as a teacher by producing their own material (I have found that this is a fantastic way to consolidate my own learning). Some people have concerns about the veracity of information “online” and in social media circles which includes FOAMed, however it is ultimately up to the individual to ensure that their sources are reliable – no different to how this used to be with hardcopy texts or “word-of-mouth” information from registrars or consultants on a ward round. In addition, most of the content produced under the FOAMed banner is produced by people who are experts in their field or at least have referenced the material that they produce so that the information can be checked. In some ways it could be said that FOAMed material is exposed to more rigorous checking and editing as it is so openly “out there” for people to critique and provide feedback on.

      Some great FOAMed resources (not an exhaustive list!) for people to look at include:
      http://foam4gp.com/
      http://ruraldoctors.net/
      http://kidocs.org/
      http://broomedocs.com/
      http://prehospitalmed.com/
      http://lifeinthefastlane.com/
      http://dontforgetthebubbles.com/
      http://www.impactednurse.com/

      (ii) ACRRM
      It is certainly still possible to obtain both a FACRRM and a FRACGP – you can do “dual fellowship”. It is up to the registrar which college they decide to go with, and if they may want to do both. I believe both colleges have fantastic resources and deliver great training, however clearly ACRRM has the rural GP focus, and RACGP offers the FARGP qualification as an extra if registrars choose to do this. The main reason I have completed the FRACGP in stead of FACRRM is because I started my GP training in outer metropolitan Melbourne (for personal reasons at the time), so I did the RACGP as a general pathway registrar, even though my aim was always to eventually go rural. You are right in saying it is rare for someone to want to jump through extra hoops and complete two Fellowships for no particular reason.

      I hope that answers your questions!
      Mel.

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