FRACS Orthopaedic Examination

by Dr Wan Zhang (exam 2021)

  • Preparation for the Exam
    • What you should read
      • Millers
      • Apleys
      • Last 5 years of JAAOS articles
      • Orthofracs Summaries … (naturally)
      • Wiesel’s
      • audiovisual (Millers MP3)
        • great for the car
    • How you should study
      • Flashcards
        • as you read articles / summaries you should be developing flashcards of core information
        • this can be done electronically such as ‘Anki’
        • there is no point reading anything, if you don’t remember it
    • Study Group
      • This is vital
      • You can not pass this exam without practising with others
      • Ideal number : 4-6
      • Frequency of meeting: weekly (twice a week in final months)
      • How should it run
        • study plan
        • criticism
        • development of study material
    • Get some advice
      • Tutorials
        • leading up to the exam, get as many tutorials as you can
          • confirm what you read
          • gives you perspective on common conditions
          • puts you under the pump
        • Subjects
          • Specialities (it is important to cover these areas)
            • Shoulder
            • Spine
            • Hip
            • Knee
            • Foot / Ankle
            • Hand and Wrist
            • Tumour
            • Paediatrics
          • Radiology
          • Pathology
      • Past registrars
        • those who have passed the exam are an invaluable resource of information and advice
    • Expose yourself to criticism and scrutiny
      • Study Group
      • Tutorials
      • Case conference
      • Outpatients
      • Meetings and Clinics
    • Set 5 preparation
      • Leave entitlements
      • Rotations
    • Bone School
      • Suit and instruments
      • Preparing
      • Presenting
      • Pressure
    • Look after your health
      • fitness
      • mental
      • dietary
    • Research Presentation
      • This is a necessary component of the Exam process
      • It is important to obtain your required research points earlier
      • Failure to do so may stop you from sitting the exam, or add to extra stress / distraction that may lead you under perform
    • AAOS Exam
      • There is a lot of contention regarding the usefulness of this practice exam and the correlation between it and the real FRACS exam
      • Your performance during this exam is probably related to the amount of study your able to do during the second have of SET 4 – which is quite variable. ie. If your SET 4 post is incredibly busy, you’re unlikely to have the time to study for this early practice exam.
      • So don’t worry if you do badly at it – you still have time to pick up your game and pass the exam.
      • Having said that. no one who has won the AAOS prize has failed the exam!
    • Pre-Exam Course (If it still runs)
      • This course is absolute gold and will allow you to polish your skills and iron out some nerves.
        • run under exam conditions
        • practice your technique
      • It is held interstate a week before the exam
      • Take it very seriously
      • It tests 3.5 parts of the 5 exam components
  • On the day of the Exam
  • How to Approach
    1. Multiple choice questions
      • Friday morning paper
      • 2 hours
      • 75 mcqs – 5 True / False (375 questions)
      • need approx 75% to pass (standardised bell curve > -1 SD below mean to score 3/4)
      • purely factual
      • only approx. 10% repeat questions
      • Preparation
        • past 5 years JAAOS articles
        • Prepare flash cards for everything you read
        • practice past questions
    2. iSAWEs and Essays
      • Afternoon paper
      • 2.5 hours
      • iSAWEs
        • 10 x 6 minute short answer questions
        • based on a short vignette and a clnical photo or xray / ct / mri
        • Preparation
          • study group – prepare practice iSAWEs
          • practice structure and timing
        • Tips
          • read the question
          • write in point form
      • Generic surgical questions
        • 2 x 15 minute short answer / mini essay questions
        • based on a context that can be generalised to other surgical specialties
      • Essays
        • 2 x 30 minute essays
        • Assesses
          • Perspective
          • Clinical assessment and investigation
          • Management – nonoperative, operative and rehab
        • Preparation
          • past papers
          • discuss in study group
        • Tips
          • Read the question
            • every word in the question is there for a reason
          • Perspective statement
          • Tailor it to specific case
          • Start with a plan and have a clear structure
    3. Investigations (CIM – Clinical investigations and management) (1 session)
      • Saturday
      • 30 minutes – 5 cases
      • Assesses
        • Clinical assessment and workup
        • Use of investigations – biochemicals, imaging, histology
      • Preparation
        • Practice with study group
        • St Vincent’s tumour meeting
        • know background of every investigation
        • know tumour principles – staging and biopsy
    4. Operative Computer Stations (Op Surg) (2 sessions)
      • 2 x operative sessions – Saturday
      • 30 minutes with 2 examiners – 5 cases
      • Preparation
        • Practice – study group, theatre, bone school
        • see as many ‘uncommon’ cases as you can
        • Hoppenfeld (approaches and anatomy)
        • Campbells / Wiesel’s
      • Tips
        • Strat with perspective statement and “answer the question”
        • Briefly mention non-operative management but remember it’s an operative station
        • say what YOU would do
        • know the principles and draw on past experience
    5. Clinical Stations (2 sessions) (Computer based if due to Covid)
      • 4 cases – 35 minutes, 3 cases – 35 min
      • History and Examination videos – can be asked to be replayed, but careful this can take away time for answers / discussion
      • Tips
        • Introduction
        • Answer the question
        • Structure
        • Wash hands and thank patient
        • Precise demonstration of signs
        • Interpretation of findings and diagnosis
        • Establish rapport