Pros: The answer is right there on the page in front of you.
Cons: It’s not always so obvious which is the right one!

Studying for the MCQ:
MCQ’s test your factual knowledge, and require that you have very specific knowledge of the the recommended texts.  Often the questions will require knowledge of specific percentages, likelihoods or what’s most common.  It is often the easiest section to start your study with, as there is an abundance of practice questions you can use to get you motivated (or scared), and it’s the most familiar format.  Most of us are professional MCQ exam sitters, but these tips can still help.

The devil is in the detail:
While reading the texts you should think about what the key point on that topic is, what’s the most likely question that could be asked, what is the main learning point, current issue, or controversy, and write your notes accordingly.  There’s no point writing swathes of notes or mindlessly summarising topics without directed, question specific goals, as these will be as tedious to read as the book you summarised when you’re revising.  While reading/summarising try & think what the examiners would pick out as a good question from the information provided.

Write your own questions
An excellent way to get you thinking about the details and cement your knowledge.  After you read a section/topic, go back and write an MCQ on that topic.  Putting “wrong” answers in will help you remember what the “right” information is.  You can get your study group to pick a couple of topics a week, divide them up, each write MCQ’s on specific topics then share them amongst your group.  This is a good way to cut down on your book time.


HINT: See our section on Proactive Use of Resources for some specific tips on how to maximise the value from your book time for the MCQ.

Only studying the topics that you see in practice questions.
Contrary to popular belief very few questions are repeated.  There is a large pool that the College uses, so don’t be tempted to take the lazy approach and only study those topics or specific points you see in practice MCQ’s. You need breadth and depth of knowledge for this section, so if you are going to use the practice questions, use them to pick the gaps in your knowledge rather than as the foundation.

Not learning specifics:
Conceptual understanding can help you narrow the choices in MCQ’s but often you will need specific knowledge to get the right answer. This is where reading/summarising the texts comes into the mix. When you are reading, analyse the information thinking about what the examiners would pick out of that paragraph as a good question.

Answering Tips:
We can’t be clearer about this.  Get into the habit of reading EVERY WORD in the question stem twice, to be sure you understand what is being asked before looking at the responses. You’d be amazed how often you can miss the “EXCEPT” at the end of the stem, or simply miss the point of the question because you are anxious or feeling rushed, and mistakenly pick one of the “correct” answers without realising they want you to pick the “incorrect” one or vice versa. Here are some tips to help you read the question more accurately:


 Trick Words

Get into the habit of double checking the stem of the question for catch words such as “always”, “except”, “never”, “most/least common”.  Fortunately other tricks like “double negatives” are uncommon but can still crop up. To make sure you don’t miss any of these “trick words” use the following techniques:

NOTE NEGATIVES: If a negative such as “none”, “not”, “never”, or “neither” occurs, know that the correct alternative must be a fact or absolute and that the other alternatives could be true statements, but not the correct answer. Also beware the DOUBLE NEGATIVE: MCQ’s with double negatives are fortunately uncommon in the ACEM Fellowship exam but they do crop up.  Remember that if you see a negative prefix such with a negative word preceding it they cancel each other out: Eg: Not uncommon = common.

NOTE SUPERLATIVES: Words such as “every”, “all”, “none”, “never”, “always”, and “only” are superlatives that indicate the correct answer must be an undisputed fact

NOTE QUALIFYING WORDS: “Usually”, “often”, “generally”, “may”, and “seldom” are qualifiers that could help to indicate a true statement


Underline, highlight or circle Laughing the “Trick Words” (as above) in the stem and the answers, so if you have to go back to that question you won’t miss them


Cover the options while reading the stem:


Use a piece of paper to cover the answer options while reading the question.  This way you can try & think of the answer without being misled by the options in front of you. This will also help you keep track of which question you’re answering.


Use the reading time to start answering:
An old MCQ technique, this is invaluable.  In the reading time you can’t pick up your pencil, but you can use your fingernail to mark the answers in the booklet.  You can buy yourself several valuable minutes doing this, so if you have trouble with later questions you’ll have some thinking time up your sleeve.

If you really don’t know the answer, skip it & move on:
There’s no point wasting valuable time trying to nut out an answer if you really don’t know it.  Make a large asterix next to the question, or circle it, and move the next question. You can come back at the end and have a guess, being sure that when you answer the next question you leave the previous answer space blank You only have about 1 minute per question (plus the reading time during which you can start marking answers in the booklet with your fingernail) so don’t waste unnecessary time fretting over a difficult question as you may run out of time & not get to answer some questions you know the answer to.

Double check you are answering the right question number:
For EVERY question, as you mark your answer check the question number with the space on the answer sheet to be sure you are marking it in the right spot.  There can be no feeling worse than getting to question 60 and realising you have already marked an answer in the box for question 60… which is actually the answer to question 59.  Trying to backtrack to see where you went wrong is almost impossible and you will likely not have time.

Circle your answer in the question booklet
This seems like common sense, but if (god forbid) you should get your answers out of sequence, you often won’t realise until the end, when you have one space left on the answer sheet or your last answer goes into the space for answer 61…  If you have marked your answers in the question book you can go back and quickly fill in the correct answers on the answer sheet.  It is rare but candidates have failed the MCQ by simply putting their answers out of sequence after they’ve skipped a question, which puts all of their subsequent answer out of sequence.

Play the odds:
If you don’t know an answer, try & narrow it down by excluding obviously incorrect answers.  Your chances of an accurate guess go up even if you can eliminate one option.    If you can get it down to two options, you have a 50/50 chance, which is better than the 20% chance you started with.

Answer Every Question:
There is no penalty for incorrect answers, so make sure that every question has an answer.  Even if you have to guess you have a better chance of getting a mark compared to zero chance for no answer.

Take a break:

Believe it or not, you will most likely finish the MCQ well before the hour is up. Try taking a few breaks during the exam by stopping for a moment, shutting your eyes, and taking some deep breaths and/or stretching. Periodically clearing your head in this way can help you stay fresh during the exam session. Remember, you get no points for being the first person to finish the exam, so don’t feel like you have to race through all the questions – even two or three 30-second breaks can be very helpful.  Practicing this technique during your practice exams (of which you should do several before exam day) will give you the confidence to use this technique on exam day, and it may prove very useful.


Watch the nervous ticks…

Have you ever been in an exam and sat behind or next to someone who jiggles their leg, spins their pen, sniffs, coughs, or throws a hemiballismus type spasm? It can be very, very offputting, and this is not the day to have your chances interfered with by someone else’s annoying habit. If you are worried about this, make sure you sit in the FRONT row for the whole exam, preferably against the wall, that way you will be exposed to minimal visual distraction. And please, be mindful of others and try to NOT be the one with the annoyng habit on the day! (to all you pen-twirling, leg-jigglers out there!).


If you are running out of time or are stuck on a couple of questions and have absolutely no idea, try to apply the following:

Responses that use absolute words, such as “always” or “never” are less likely to be correct than ones that use conditional words like “usually” or “probably”.

 “All of the above” is often a correct response. If you can verify that more than one of the other responses is probably correct, then choose “all of the above”.

“None of the above” is usually an incorrect response, but this is less reliable than the “all of the above” rule. Be very careful not to be trapped by double negatives (see above)

Look for grammatical clues. If the stem ends with the indefinite article “an,” (for example), then the correct response probably begins with a vowel.

The longest response is often the correct one, because the instructor tends to load it with qualifying adjectives or phrases.

Look for verbal associations. A response that repeats key words that are in the stem is likely to be correct.

Opposite options: If two options are opposite each other, chances are one of them is the correct answer.

If all else fails, choose response that caught your eye. There is some evidence that “gut” reactions can help improve your score.


(Don’t change your answers):
This is a controversial tip, (hence the brackets) so much so that we may delete it at some point.  Many academics argue that your first impression, or gut instinct will be the correct one.  There is no evidence we’re aware of to support this.  The fact is you may pick the wrong answer first, and have a flash of inspiration or a memory triggered by a later question that inspires you to change your answer. Enough said, just be aware of this & see how you feel on the day…


Next:  VAQ & SAQ – General Concepts

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