Practice for your oral technique in the shower


Ok so this is nowhere near as lurid (or entertaining) as it sounds. One of the cornerstones to developing a successful oral technique for radiology exams is practice. The majority of this practice, as I discussed in the previous post on how to effectively practice for oral radiology exams, and not waste time should be on your own where you have the opportunity to work on each film, breaking down an oral exam into individual types of films. You can however take a step even further back by practicing the phrasing and choosing the words you want to use without the distraction of an actual film.

This might sound silly, but the last thing you want to be struggling over is how to phrase your discussion on the day of your exam. During your viva your mouth should be on autopilot, freeing your mind (what's left of it) to think about the case. To get to this point you must have developed a consistent presentation style. This acts as scaffolding upon which you hang stock phrases. The best way to do this (although this is not very time effective) is just to report thousands and thousands of films in your day to day work; this is of course something you should all be doing. Unfortunately exam cases are a different subset of real life cases. 

One way to create a polished style is to visualize a case and start talking, paying attention to the words and not the particulars of the case. A great place to do this is the shower, but of course you can do this anywhere else you are alone with some time to kill, and free from too many distractions.

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The sort of questions you should ask yourself during this exercise are:

  • does what I am saying make sense?

  • am I implying something I do not wish to imply? (e.g. if you use the term “cystic” when describing a necrotic glioma, the examiner may well wonder if you are thinking about low grade tumor, and later wonder if you understand what the word “cyst” means)

  • is my terminology precise? (e.g. one of my pet hates is the use of the word "density" rather than "intensity" when describing the appearance on MRI)

  • are my descriptions clear and concise? (e.g. when describing a mass, logically work your way through its macroscopic appearance, imaging features, relations to surrounding structures etc… 

  • am I clearly separating my description from discussion? Nothing creates the sense of confusion than jumping between findings and interpretation. 

  • am I including relevant negatives but not too many irrelevant ones? Think ahead of the differential you are going to entertain and make sure you touch upon the features of each. 

By practicing in this way, in or out of the shower, you should find that your presentation will be more polished and as a result you will be able to articulate the knowledge you have better.

Remember... (this is important, so pay attention): spending a few hours improving your technique will improve every single case you every get shown in your exam. Spending the same amount of time reading about a specific topic will probably result in no improvement, as you are unlikely to be asked about that particular condition. So unless you technique is awesome and much better than your knowledge, you should be spending more time in the shower. 


Next: Islands of knowledge or puddles of ignorance


Dr Frank Gaillard is a neuroradiologist at the Royal Melbourne Hospital, Melbourne, Australia, and is the Founder and Editor of

NB: Opinions expressed are those of the author alone, and are not those of his employer, or of


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Publication date: 23rd Mar 2014 02:42 UTC

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