Written Exam – General Concepts

The written exam is notoriously difficult, it’s the first stumbling block, and the “culling” process whereby those smart enough to be allowed to have a go at the clinical exam are selected. You will also spend the bulk of your time studying for the written exam, although most of the factual knowledge will carry over to the clinical exam, the way you reproduce it is very different, and necessitates some different learning strategies, and quite different exam technique skills.


The exam is in 3 parts, held on one day, at one venue in each capital city (ie you don’t need to travel interstate for it).  The clinical exam however is only held in one geographic location, and you’ll most likely need to travel to get there, and this may mean going overseas if you live in Aus and the exam is in NZ (or vice versa).


The 3 sections of the written are the MCQ, VAQ and SAQ.  They each test different learning, knowledge, prioritisation and communication skills.  The best way to get your head around what each section entails is to read the Training & Examination Handbook section on the Fellowship exam, and become intimately familiar with the rules, the timing and the marking scheme.  Each section has it’s own unique marking system, and the way the marks are collated and how they affect your final result (when combined with your marks from the clinical exam) is also something you should be intimately familiar with from the start.  This way you can guage your progress as you start doing more practice exams, and see where your weak spots are.  On the following pages we have collated section-specific study and exam sitting advice for each section of the written exam.

You need to do at least TWO full practice exams (preferably more), under exam conditions, start to finish, before the written exam, and have them marked by an examiner.  In some states certain hospitals will run mock exams prior to the writtens and will mark your papers to give you a sense of whether you’re ready to sit.  If you fail these practice exams, or just pass, you need to sit down with your DEMT or tutors, and have a serious talk about whether you’re ready to sit.



Planning ahead and taking into consideration the following issues may help you have a somewhat better day:

Where is the exam venue?

How will I get there?

If driving where is the car parking, and how much does it cost?

If driving what is the peak-hour traffic going to be like on that day? (Is it worth doing a practice run a few weeks before so you don’t get caught out, & know which route you’ll take?)

What is my backup transport plan if my car won’t start, the trains are on strike or there’s a big storm & I have to wait an hour for a taxi? (ie make sure you have money/credit card for a taxi)

If you live far away would you be better spending the night before in a hotel close to the exam venue?

Or do you sleep better at home, and would a longer drive/train ride in on the morning be preferable?

Do you have young children? If so should they be farmed out for a couple of nights before the exam to ensure you get a decent nights sleep?

What will you eat in the morning (you need to get the balance of sustenance vs anxiety related nausea vs catecholamine related irritable bowel right).

How much caffeine can you safely consume with breakfast/throughout the day without “peaking-out” or “crashing too early”. Remember the exam goes ALL DAY, and you need to pace yourself.

What food/snacks will you take with you?



You need to take the following items with you:

Pencils, sharpener, eraser for MCQ

Pens (black or blue) for the VAQ/SAQ. You should take at least 5 of your favourite easy-to-write-with pens.


Stopwatch/timer – make sure you have a silent (non-beeping) one that you are very familiar with.  The exam room co-ordinators have a clock and will often mark off time on a whiteboard but if you have a timer you are comfortable with, then use it.  DO NOT use a new timer for the first time on exam day! Consider taking a backup one with you in case your main one packs up.

Lollies/Water/Juice/Gatorade/Caffeinated beverage: for sustenance.  BUT Remember the SAQ goes for 2 hours, so be mindful of your fluid intake/ouput prior to this section – ie you don’t want to be distracted by a distended bladder at the 30 minute mark, and remember: caffeine acts as a diuretic, your BP (and hence your afferent arteriole pressure in your glomeruli) will be higher, so you’re urine output will be increased, so don’t down a 600ml Coke before walking into the SAQ or you may need a urologic/renal referral afterwards…

Lunch and other low GI snacks to have during the breaks.

Medication: if you take regular medication make sure you have spares with you. If you do suffer from anxiety related bowel issues then taking Loperamide in the morning is unlikely to affect your performance, but beware of Maxolon’s side effects that include somnolence and akathisia (neither of which you want on the big day), and be very careful with sleeping tablets. You may feel OK the next day, but remember they work by inhibiting CNS neurones, and you want every one of them firing on the day.

Your identification and exam candidate number.

Cash for the pub afterwards!




Next: MCQ

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