Cases, discussion &amp; exam tips.

upper limb

FRCS short cases: the upper-limb station timing lesson

I learned to structure the 6-minute hand and shoulder cases by leading with the key positive finding and diagnosis before expanding to investigations. Practising with a timer on real patients in clinic prevented me from over-describing irrelevant negatives. This kept the examiners engaged and left time for management discussion.

spine

Viva on spinal stenosis: admitting the evidence gap

When pushed on whether to fuse every degenerative spondylolisthesis case, I initially hedged. The examiners wanted a clear position backed by the RCTs they referenced. I now prepare two-sentence summaries of the key trials for each major controversy so I can state my practice and the supporting or conflicting data without waffling.

paediatrics

Paediatric clinical case: always examine gait first

My unprepared clubfoot case went poorly until I demonstrated the full gait assessment before touching the foot. The examiners explicitly praised the systematic approach. From then on I began every paediatric case with observation and gait, even if the referral mentioned only a hand or spine issue.

FRACS operative surgery viva: drawing the approach

They asked me to draw the posterior approach to the humerus on the whiteboard. I had practised this on paper but the pressure made my lines shaky. I now rehearse drawing all common approaches life-size on a whiteboard at least three times before the exam so the motor memory is automatic.

EBOT oral: handling being corrected mid-answer

I started describing the wrong classification for a pelvic fracture and the examiner gently redirected me. Instead of freezing, I acknowledged the correction and immediately restated the correct classification with the modification. They later commented that graceful correction handling was a marker they looked for in borderline candidates.

basic sciencetumours

Mock viva failure on basic science: the histology trap

I was shown a slide of giant cell tumour and launched into management without describing the histology. The examiners stopped me and asked what I saw. I now force myself to spend the first 30 seconds describing the microscopic features aloud even when the question seems purely clinical.

foot ankletrauma

ABOS case log review: the complication I had to defend

One of my logged ankle fractures developed wound breakdown. The examiners spent five minutes on my post-operative protocol and antibiotic choice. Having the actual operation note, culture results and follow-up photos ready allowed me to defend the decision logically rather than appearing defensive.

Weekly case conference with evidence update

Every Friday I review one interesting case from the week with two colleagues, each presenting the current guideline recommendation and one recent paper that might change practice. We limit discussion to 15 minutes per case and store the references in a shared folder. This keeps knowledge current without overwhelming reading lists.

Drawing surgical approaches from memory on alternate days

I alternate between drawing the surgical approach and the relevant cross-sectional anatomy for one procedure each day. I check against an atlas immediately after and correct errors in red. The physical act of drawing plus immediate feedback has improved my operative viva performance more than reading alone.

Building a personal differential tree for each common presentation

For every frequent referral (e.g., painful total hip, foot drop, paediatric limp) I maintain a one-page decision tree on a single A4 sheet. I update it whenever new evidence appears and review the whole set the week before the exam. This prevents the blank-mind moment when an examiner changes the stem slightly.

Recording and transcribing 10-minute viva answers

I record myself answering a full viva question then transcribe it verbatim. Reading the transcript reveals filler phrases and logical gaps I never notice while speaking. I re-record the same question after editing the transcript until the answer is under eight minutes and contains no repetition.

Monthly guideline comparison table

I maintain a living table comparing BOA, AAOS, and NICE guidelines on the same topic side-by-side. Differences in recommendation strength are highlighted. Reviewing this table every month has helped me answer the common exam question of "what does the evidence/guideline say in your country?" with precision.