How to Practise Viva Answers When Studying Alone

Most orthopaedic viva preparation assumes a study partner or a consultant to question you, but training rotas often leave you revising alone. You can still rehearse the skill the viva marks, which is spoken, structured reasoning under time pressure, if you build the missing examiner into your routine. This article covers the drills that work on your own. For how vivas are marked and how to structure an answer, read how to pass the orthopaedic viva first.

Fix the structure before you rehearse it

Without a partner to steer you back on track, the structure has to come from you, and it has to be the same every time. For clinical scenarios:

1. Patient first. In trauma, resuscitation on ATLS principles before the limb.
2. Focused history and the examination findings that would change management.
3. Investigations in steps, starting with orthogonal plain radiographs.
4. Diagnosis and classification, then what the classification means for treatment.
5. Options, your choice and why, then complications and follow-up.

Say the scaffolding aloud as you practise ("First I would assess and resuscitate the patient. Second, a focused history…"). The commonest solo failure is starting with the pathology or the operation before showing that the patient is safe and the limb's neurovascular status is known. Speaking the order each time makes it the default under pressure.

Record yourself and audit the playback

Most people sound more coherent in their heads than on a recording. Write viva topics on cards, start a voice memo, allow five seconds of reading time, then answer aloud as you would in the room. Record a block of five to ten minutes, then listen back with a notepad and tally:

• Filler words: "um", "er", "like", "basically".
• Backtracking: how often you restart a sentence.
• Pace: rushing, running out of breath, or long silences.
• Unexplained terms: a technical word you used without showing you understand it.

Re-record the same answer until the tally falls. The aim is not a script; it is a structure you can deliver cleanly on any topic.

Run timed rounds that force you to switch topics

Alone, it is easy to spend forty minutes reading about one rare paediatric foot deformity. In the viva the examiners control the clock and move you on. The RACS orthopaedic notes to candidates (opens in a new tab), for example, set five scenarios in each 30-minute computer-based viva and 9 minutes for each video scenario in Clinical Cases 1.

Put varied topics on folded slips in a bowl and set an interval timer to three minutes. Draw a slip, answer at once, and stop when the timer sounds, even mid-sentence. Draw the next slip and start fresh. The drill trains two things: giving the headline and the key decision early, before time runs out, and resetting after a weak answer instead of carrying it into the next question.

Rehearse presenting images, not just reading them

Orthopaedic vivas are visual, whether the image is on paper, a screen or, in the RACS Clinical Investigation and Management and Operative Surgery vivas, a computer. Looking at a textbook radiograph and muttering the diagnosis does not train the performance.

Place an empty chair opposite you as the examiner. When you reach an image in your revision, present it aloud in a fixed order: "This is an anteroposterior and lateral radiograph of the right wrist of a skeletally immature patient." Then the main abnormality, the soft tissues and a one-sentence synthesis. For questions on surgical approaches, sketch the limb, mark the incision and name the structures at risk as you describe each step, for example the superficial radial nerve in a first dorsal compartment release.

Question yourself the way an examiner will

The JCIE's structured oral question-writing guidelines (opens in a new tab) for FRCS Section 2 tell examiners to avoid simple recall ("list, define, what is") in favour of open questions, and to use "what if?" to probe problem solving and "and why?" to probe reasoning. Build those two prompts into every solo session.

Write branching question chains for basic science and anatomy. Start with "Describe the brachial plexus." Once you have answered, become the examiner: "What are the branches of the posterior cord?" "What are the signs of an upper trunk injury?" "How does a lower trunk lesion differ?" Then add a "what if?": an unexpected finding in theatre, a complication, a new result. Where you hesitate or stall, mark the exact point, return to the source and re-run the chain the next day.

Practise saying what you do not know

Bluffing is one of the fastest ways to lose an examiner's trust. The RACS orthopaedic notes ask candidates who have not managed a situation to acknowledge it and describe their management "from your reading and planning". Solo practice is the safest place to rehearse that.

When a recorded answer hits a gap, do not stop to look it up. Say the gap aloud and then give what you can:

• "I don't recall the eponymous classification, but anatomically this is an intra-articular, multifragmentary fracture with dorsal comminution, which makes it unstable."
• "I have not performed that procedure. From my reading, I would plan it as follows…"
• "If this happened in theatre, I would stop, make sure the patient is stable and call a senior colleague, and my plan to present to them would be…"

Each phrase admits the gap and still gives the examiner something safe to mark.

Build a full mock circuit

Piecemeal practice does not build the stamina of a viva day: FRCS (Tr & Orth) Section 2 alone includes four 30-minute orals, according to the JCIE Trauma & Orthopaedic Surgery regulations (opens in a new tab). Book a quiet room, leave your phone elsewhere, and take only a pen, paper, a clock and a set of unseen questions and images. Run a continuous circuit of two to three hours without pausing the clock for drinks or textbooks.

Notice what fatigue does to you: slouching, a quieter and flatter voice, fragmented sentences. Knowing your pattern lets you correct it on the day.

Solo work has limits. It cannot reproduce an examiner who interrupts, changes the scenario or pushes back, so use it alongside mock vivas with consultants when you can get them. The RACS notes also suggest treating every patient you see in clinic before the exam as a potential medium or short case. For the opening statement on a clinical case, see orthopaedic short case presentation.