For this first post in my planned series on how to prepare for radiology oral exams: essential techniques, I wanted to make a golfing analogy (stifle groans please), but you can replace any sport of your choosing if it helps.
If you want to get good at golf you do not simply play round after round after round. Although you will certainly improve, it does not offer the opportunity of working on problem areas; after all in 18 holes you may only get to use a particular club a few times, or putt from a certain distance a few times. Playing a full round exists mainly identify the areas you need to work on.
So lets say you play 18 holes and you notice that you miss three 6-foot putts. Your next task is to go to the practice green and hit hundreds of 6-foot putts. If that still doesn’t help, then you need to work out what you are doing wrong, and you may need to read some articles on putting, or get a pro to give you a hand etc…
The same applies to practicing for oral exams. Too many of the trainees I see do the vast majority of practice cases in a group, either in tutorials or in study sessions. In both situations the cases are looked at once in an 'exam style' before moving on to the next case. Moreover these sessions usually contain a relatively random assortment of conditions, at most restricted to a system. It is no surprise that I see these trainees make the same mistakes over and over again.
As a rule of thumb you should probably be doing 10 times more cases on your own than you do in a group. Furthermore when you do cases on your own, you don’t do them the same way as you do in a tutorial, but rather you practice them, until they are nice and polished.
This was my routine (for a ~40-60min study block):
pick a topic (e.g. bronchiectasis on chest x-ray, including causes such as ABPA / CF / idiopathic bronchiectasis etc… )
pick conditions that can look similar (pulmonary fibrosis, interstitial edema, sarcoidosis, asthma etc..)
get a pile of films or create a playlist on Radiopaedia.org (e.g. here is one I created earlier)
look at the first case and verbally present it as if you were doing it in an exam (you may want to record yourself)
check the answer
go back and do it again now knowing what the answer is and try and make your presentation as polished as possible, including relevant positives and relevant negatives. Really try and make the language you use tight and unambiguous.
move to the next case
As you try and complete step 6 you will probably find that you uncover areas that you are not certain about (e.g. what is the distribution of bronchiectasis in ABPA). This is knowledge you need to know if your presentation is going to be perfect. Because you are on your own, you can then turn to your trusty textbook or favorite online resource (no prizes for guessing which one I would recommend) to find out the answer. Then you incorporate that into your presentation as you practice it once more.
This might seem tedious, but by the time you have done a dozen cases in this manner, you will have perfected your approach to this whole group of conditions and be able to knock any similar case out of the park.
Next: Practice for your oral technique in the shower
Dr Frank Gaillard is a neuroradiologist at the Royal Melbourne Hospital, Melbourne, Australia, and is the Founder and Editor of Radiopaedia.org.
NB: Opinions expressed are those of the author alone, and are not those of his employer, or of Radiopaedia.org.