Professor Christopher Halloran, Depty Dean - Surgical Examinations, sits down with Professor Martin Griffiths, FRCS Examiner, to determine what makes a good examiner.
How do you find examining the FRCS in general surgery?
Firstly, it’s an absolute privilege to be an examiner. The opportunity to ensure that standards of professionalism, integrity and practice is one I’d encourage all senior practitioners to consider. It also helps you to identify gaps in your own training practice which has really helped me teach aspiring candidates better.
What does a good day examining look like?
A good day? I’m rested, I’ve done the prep and actively contributed to the calibration and practice meetings (ensuring that the questions are fair and reasonable and we know what the clear pass/fail points are) and I’m comfortable with the material. I’ve spent time with my partner examiner and ensured we’re agreed on the questions we are going to ask, have checked the tech and the supplied information and have agreed how set and manage the pace and approach to the exam. Ideally the examining room is well appointed with adequate space light and temperature, and we have access to timing and materials. We run to time (so important) and the candidates are presented to us ready to be examined (not stressed, hurried, or have incomplete documentation and credentials). We work as a team asking questions in a professional manner, covering as much ground as we can per question and give the candidate adequate opportunity to demonstrate their knowledge. We actively consult with and engage the patients to ensure they are contributing to the assessment. When the candidate leaves, we mark and then confer and find that we’re closely aligned. Struggling candidates are moved thru topics to ensure we don’t miss areas of knowledge, and we act compassionately and fairly throughout. We get breaks and finish on time with a capacity and time for a thorough and timely debrief focusing on what we can demo better next day and time. I listen actively to the feedback from my observer and colleague and reflect on it to improve my performance the next day.
And a bad day?
A bad day. Late and poorly prepped and allocated at short notice to a discipline I haven't’ planned for. Unhelpful calibration meeting. Paired with multiple examiners with differing styles and views on what good looks like. Sessions not running to time with poorly prepared candidates who are flustered before we start. Technical failures. Phones going off during exams. No breaks. Poorly prepped clinical patient, adversarial candidates or patients. Overly long day that leaves us all tired and grumpy with an incomplete debrief.
Any Tips?
No real magic here. Know your topic and bring your own timer. Be as kind as you possibly can - it’s an incredibly stressful experience so don’t add to the atmospheric. Be objective and consistent. Work WITH your examiner colleague - use them as a reference or patient for role-play. If there an issue of understanding ask them to draw a diagram to explain the anatomy, this is really helpful if you’re struggling to hear clearly. Grammar beats accent, so listen actively and ensure you’re hearing all the words the candidates are using. When documenting QUOTE DIRECTLY don’t paraphrase - really important in pass/fail questions. Pass safe practice, even if it might be illogical or inelegant. This is not about you, so bringing your personality or local practice into the questioning is unhelpful. Don’t take it personally (not wearing a tie isn’t a pass/fail issue) . Cover the ground move on if the candidate is struggling with a sub-topic and work with their tempo. Remember, the candidate has already passed the knowledge test, focusing on this aspect will bias your technique. No teaching, no coaching. Put your phone away and ideally off and nowhere near you. If it’s in your pocket, you’ll inevitably look at it. Even if it’s on silent, the notifications or vibrations are a distraction and easily picked up by all. Make sure the clinical patient does the same. Don't be swayed by good/bad candidates stick to the guidelines that we agreed and don't move the goalposts. A minimally competent day one surgeon isn’t going to shine in the exam, but they will be safe.
Professor Christopher Halloran, Deputy Dean - Surgical Examinations
Professor Martin Griffiths CBE DL FRCSEd, Trauma Surgeon Barts Heath NHS Trust