UK Elective 2019 - Exams week in Edinburgh

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For the last few years applicants who came second or third in the FPHC Student UK Elective process have been offered the chance to spend a couple of days in Edinburgh during one of our exam weeks to get a ‘view behind the scenes’ of part of what the Faculty does. The last two do do this (January 2019) have written a combined report of their experiences and thoughts thereof.

'We arrived fresh in a very wintery and frosty Edinburgh for our first day of observing the January DIMC and FIMC examinations and managed to meet quite a few new faces at the College before starting properly. The first day is all about setting up ready for the exams taking place the following day and making sure that the examiners are all on board with how to assess candidates and are therefore assessing to the right standard. This involved discussions about the minimally competent candidate and how to recognise them. We then took part in standard setting the single-best-answer questions. Although, as undergraduate students, our considerations of the difficulty level of each question did not contribute to the final standard setting, we were still able to engage with the process and develop an understanding of the steps involved and subsequent deliberation that went into each question. This was fascinating and we learnt a lot of medicine too!

In the evening we were treated to dinner with the other examiners, which was really fun and a great opportunity to learn more about everyone’s individual career pathways and experiences. We also heard an inspiring talk by Andy Thurgood. He spoke about the true realities of PHEM, how we need to take care of each other and how we work in effective teams irrelevant of our titles.

The next day we were off into full exam mode on a strict timetable which reminded us of our own recent OSCEs… this was hard evidence that medical school really is just the beginning! It was fascinating to watch how the candidates approached each station, and how visibly different styles could all achieve that minimal level competence or above. It was interesting seeing the different reactions to each station and discovering that the stations that were the differentiators weren’t always the ones you would expect. We were also lucky enough to watch the Fellowship candidates undergo the simulation scenarios. These are much longer, more complex and much more medically challenging. They were really interesting to observe as throughout the scenario you were constantly thinking as if you were in the candidate’s shoes and considering what you might do; trying to anticipate what medical management or decision-making might happen next!

Watching the Fellowship candidates again in the shorter OSPE’s the following day demonstrated how much more advanced they were compared to the Diploma candidates, and it was intriguing to watch their different styles and approaches to patients. The Faculty discussions post the exam were also fascinating. Having watched a scenario be played out over fifteen times, you become intimate with its failings and positives. Therefore, the examiners for each station become perfectly placed to offer their opinion on aspects that may not have been apparent when the scenarios were first conceived. This all contributes to quality improvement for the development and implementation of future examination cycles. It clearly showed how keen everyone in the Faculty is to improve the exam and make it as good as possible.

Finally, we observed a question-writing session which demonstrated the challenges and nuances of writing a true single-best-answer question that not only tested the IBTPHEM PHEM curriculum but was evidence-based and unambiguous. This helped us to understand the difficulties of writing for postgraduate examinations and helped us appreciate the similar investment that will have gone into the writing of our undergraduate exams. It was also a good opportunity to explore the PHEM curriculum and appreciate the competencies required in order to be recommended for a certificate of completion of PHEM sub-specialty training.

We learnt so much from this experience; not just about medicine and the pre-hospital environment but also about general examination structures, PHEM structure and training programmes. Everyone we met was enthusiastic and very keen to increase undergraduate participation in PHEM. Getting to know the examiners over the three days allowed us to build the professional relationships that will hopefully facilitate increased undergraduate involvement over the coming years. Attending the FIMC and DIMC is a great lead-in to get more involved in PHEM and to understand why continuing professional education, simulation and examinations are so important from undergraduate level all the way through to consultancy.

Thank you to all at the Faculty of Pre-Hospital Care of the Royal College of Surgeons of Edinburgh for kindly hosting us, we thoroughly enjoyed the experience and will hopefully see you all again soon.'

Izzy Fitzgerald, University of Exeter

Jack Sheppard, Cardiff University