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What to do when you don't get through...GP Exams

Human beings don’t like to fail.   Doctors are terrible at it.  It’s hard, especially when that failure is linked to your self-esteem, professional image, and livelihood.   It’s especially hard at the moment with the additional demands placed on our profession and healthcare system during a Pandemic.   

But sometimes, the strong emotions that accompany failure, stop us from taking the time to consider why we may have had that outcome in the first place. Consequently, we habitually reattempt assessment without reconsidering our approach – which can often lead to an unchanged outcome.  

What do we do when a patient keeps coming back with the same unresolved symptoms?  We usually try a few alternative treatments, perhaps increase a medication dose, whilst at the same time re-enquiring as to their initial symptoms, checking for red flags, and safety-netting.   If they are still not getting better, we usually go right back to basics – retake the history again, re-examine, review the results of any investigations, perhaps read around the topic – and then reconsider what might be going wrong.   If we are still stuck, we ask for a colleague’s insight.  This approach works for reattempting assessment as well.

The reasons for having difficulties completing assessment fall into three categories:

Knowledge

  • Poor baseline knowledge.
  • Not enough study.
  • Not studying the right things.

Skills

  • Superficial learning – cramming, studying using the wrong techniques, learning resources verbatim.
  • Not contextualising knowledge, i.e. how to apply it to patients.

Attitudes

  • Lack of commitment to General Practice as a career – this has been documented in research as a contributor.
  • Personal issues affecting the capacity to study.
  • Believing that the exams are ‘bad’ and ‘unfair’.
  • The belief that without having an FRACGP you will not be a good doctor.

The Triangle of Success (below) articles these points well.  Why not take a minute to reflect on which aspects of the triangle may have influenced your assessment performance?

Reference

Hopefully the triangle above will have prompted some clear reflection.  Gaining the FRACGP will make you a better GP, but you can still be a good doctor without it.   Reattempting GP exams requires the motivation of a clear end-point and goal about where you want to be, and what type of practice you would like to do in many years time, in General Practice.  There is the added burden of ‘study fatigue’ after studying for many years, in addition to poor self-confidence and lack of self-belief due to constant unsatisfactory attempts.

Re-attempting assessments needs to involve structured decision-making.  Consider the following points:

  • Give yourself time and permission to think about the situation.  Be kind to yourself through the process.
  • Consider if you might have study fatigue and where your confidence is sitting – address these two things before taking any next steps.
  • Use the following flowchart to define your decision-making.
  • Write your decision down and the reasons that support it.   Share with a colleague or mentor.  It can be useful to discuss the situation with someone not involved in medicine too.   Consider if speaking with a psychologist, Medical Educator or Medical Career counsellor might be helpful.  Having a chat to your GP is a good idea too!
  • Based on your decision – make a plan – and stick to it!

If you keep doing things the same way, you will get the same result!

Assessment In Medicine (AIM) Consultations

If you’re unsure about why you are having troubles satisfactorily completing assessment, book an AIM consultation with a Medical Education Consultant to find out why, and plan for the future.

Assessment Preparation Resources

Not sure what you need to prepare for your next attempt?   Try our Quiz to ensure you expend your resources efficiently.  

Professional Enrichment Program (PEP)

Lack of confidence in assessment preparation and GP work can be crippling.   Take the time for self-care and the opportunity to enhance your confidence with out Professional Enhancement Program (PEP).

Career Counselling for GPs

Medical Career Planning – Dr Ashe Coxon is a GP, Medical Educator and Medical Career Planner who can assist you in planning your way forward.

Please feel free to comment.

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